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Impact of manufacturer rebate proposed rule on Part D benefit parameters29 March 2019 - By Katie Holcomb and Michelle Klein - Article

Milliman modeled several scenarios to understand the expected impact of the changes to current Anti-Kickback Statute safe harbors on the standard Medicare Part D benefit parameters.

Medicare Part D diabetic member cost sharing: Impact on non-low income members04 March 2019 - By Katie Holcomb and Michelle Klein - Article

This paper explores how member cost sharing has changed over time for Medicare Part D non-low income members taking diabetic medications.

Could 2019 be the year of MLR rebates for ACA issuers in the individual market?04 March 2019 - By Esther M. Blount and Michelle Klein and Alison Fasching - Article

As medical loss ratios (MLR) decrease, individual ACA issuers need to start thinking about something that has been mostly irrelevant to them until now—MLR rebates.

The “Rxisk” of adjustments in 2018 ACA risk adjustment18 August 2017 - By Alan Vandagriff and Jason Petroske and Michael T. Hunter and Michelle Klein - Article

The Centers for Medicare and Medicaid Services (CMS) is adding a new prescription drug category classification system to the 2018 risk adjustment model, and this paper approximates the likely CMS mapping based on the publicly available information to date.

Will Repeal and Replace of the ACA cause pent-up demand to occur?23 March 2017 - By Kimberley K. Hiemenz and Michelle Klein - Article

This paper analyzes the impact of insureds utilizing more elective services in 2017 out of fear of losing or having reduced coverage with the repeal of the Patient Protection and Affordable Care Act (ACA).

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