Highlights of 2010 Medicare Advantage Application Process

1. 1 Highlights of 2010 Medicare Advantage Application Process Helaine Fingold, Senior Analyst Division of Medicare Advantage Operations

2. 2 Automated Application The 2010 Medicare Advantage application process is automated. All Medicare Advantage applications and guidelines have been consolidated into one application. All instructions for completion are integrated into the application. HPMS has a user guide to help applicants complete the automated application. The application must be filed between January 6 and February 26, 11:59 PM (EST). The automated application must be fully completed and electronically submitted to CMS � no exceptions and no hard copies.

3. 3 Consolidated Application Characteristics of the 2010 Medicare Advantage Consolidated Application: Information that was common to all applications is combined in one section. Information that is specific to a particular application has its own section. The same application for Initials and Service Area Expansions (SAEs).

4. 4 Organizational Types INITIAL Coordinated Care Plan (CCP) Regional PPO (RPPO) Private Fee For Service (PFFS) Medicare Savings Account (MSA) including demos SERVICE AREA EXPANSION (SAE) Add Counties or States to the approved area of the MAO

5. 5 CONSOLIDATED APPLICATION SEVEN PARTS General Information Initial Service Area Expansion Instructions for Completing forms Summary of Requested Documents CMS Regional Office Contact

6. 6 Application Format Changes Application consists largely of questions and attestations. Few open-ended questions and documentation requests. Qualitative responses still needed for key info. ex. HSD Tables Organizational Charts Provider and Administrative Contracts State License or Certification State Certification Form

7. 7 Application Communications Deficiency Notification Letter � Early April Intent to Deny Letter � Late April Application Denial or Conditional Approval � Mid May Withdrawal of Counties or Entire Application � Before Date of Denial Letter Withdrawal must be submitted in writing Bid must match requested service area

8. 8 Feel Free to Contact Me: Helaine Fingold 410-786-5014 Helaine.Fingold@cms.hhs.gov