GuidanceGuidance

Guidance

CMS guidance documents related to Part C benefits policy.

Questions & Answers

Answers to previously asked questions.

Resources

Resources if your questions do not relate to Part C benefits policy.

Please review the available guidance documents and the resources below that may answer your question.

Contract Year 2025

Updates and Timeline for Contract Year 2025 Plan Benefit Package (12/01/2023)

Contract Year 2024 Part C and Part D Baseline Out-of-Pocket Cost Models (12/19/2023)

Contract Year 2024

Final Contract Year CY 2024 Standards for Part C Benefits, Bid Review, and Evaluation (04/14/2023)

Total Beneficiary Cost Data for CY 2024 Bid Preparation (04/20/2023)

Update Regarding CY 2024 Part C Bid Review OOPC Model (05/16/2023)

Update Regarding Contract Year 2024 Part C Bid Review Out-of-Pocket Cost Model (07/24/2023)

IRA Part B Rebatable Drugs and Insulin FAQs (07/13/2023)


Recent Regulations


Contract Year 2023


Contract Year 2022


Other Reference Material

Answers to previously asked questions

Following are available resources if your questions do not relate to Part C benefits policy:

Questions specifically related to the Medicare FFS Average Sales Price (ASP) files may be directed to: Sec303ASPdata@cms.hhs.gov

If your question is regarding the Inflation Reduction Act, please submit the question to: IRARebateandNegotiation@cms.hhs.gov 

Policy related fiscal soundness questions, please submit an e-mail to: FinancialReview@cms.hhs.gov

Technical questions about the Out-of-Pocket Cost (OOPC) model, please submit an email to: OOPC@cms.hhs.gov

Part D benefits questions, please submit an email to: partdbenefits@cms.hhs.gov

Bid Pricing Tool (BPT) questions, please submit an email to: actuarial-bids@cms.hhs.gov

Medicare Medicaid Program, please submit an email to: mmcocapsmodel@cms.hhs.gov

Part C Medicare Advantage policy questions, please submit an inquiry via: https://dpap.lmi.org/DPAPMailbox/

Medicare Advantage Value-Based Insurance Design (MA-VBID) model questions, please submit an e-mail to: VBID@cms.hhs.gov

Risk adjustment questions can be directed to riskadjustmentoperations@cms.hhs.gov

Appeals Policy questions, please submit inquiry via: https://appeals.lmi.org/

Enrollment and Eligibility Policy questions, please submit inquiry via: https://enrollment.lmi.org

 
Question

Ask a Part C Benefits Question

Please review the available guidance documents and resources described above before submitting a question.