Beneficiary Ever Having.........

Tkruger

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So word on the street is that if a Medicare beneficiary has ever had an MAPD or PDP that commissions on that product are prorated due to having creditable PDC.

CMS apparently sent out clarification last week and commissions are seeing the impact.


Anyone have further information on this? I've not seen the CMS guidelines\notices on this.


Thanks in advance folks.
 
So word on the street is that if a Medicare beneficiary has ever had an MAPD or PDP that commissions on that product are prorated due to having creditable PDC.

CMS apparently sent out clarification last week and commissions are seeing the impact.


Anyone have further information on this? I've not seen the CMS guidelinesnotices on this.


Thanks in advance folks.

So, if a mb is enrolled on D-SNP from 1-1-16 thru 8-1-16 and then re-enrolls into a D-SNP for 2-1-17, it would be paid for 11/12 of commission, but NO TRUE-UP even though mb would be coming off of a NEW to MEDICARE situation?
 
So, if a mb is enrolled on D-SNP from 1-1-16 thru 8-1-16 and then re-enrolls into a D-SNP for 2-1-17, it would be paid for 11/12 of commission, but NO TRUE-UP even though mb would be coming off of a NEW to MEDICARE situation?

Honestly, I've not even seen an example of what the pro-ration is. Thus the question to the boards.

From your example it would elude to another non commissionable scenario I've heard scuttle about. Specifically carrier re-enrollment being non-commissionable.

New realm for me here on this. Again, further clarification and real world examples are appreciated.
 
Honestly, I've not even seen an example of what the pro-ration is. Thus the question to the boards.

From your example it would elude to another non commissionable scenario I've heard scuttle about. Specifically carrier re-enrollment being non-commissionable.

New realm for me here on this. Again, further clarification and real world examples are appreciated.

On my Humana contract, it states that they don't pay for an MA re-enrollment within a 12-month period. But, they have paid me anyway when it has happened.
 

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