Fr Sr Part I General Rules.pdf

The Model is designed to take advantage of the current market, which is for the most part, administered by prescription drug plans (PDPs) and Medicare Advantage Prescription Drug Plans (MA-PDPs) that are administered through their own plans. Under the Model, Medicare beneficiaries would be able to enroll in either a PDP or an MA-PDP, which would act as a Part D sponsor for this purpose. A single-issue Part D plan would be able to offer three or more generic equivalents of the brand name product. Beneficiaries would be able to switch plans at any time without incurring copayments or other out-of-pocket costs.

The Medicaid program uses a voluntary budget-neutral model where the health plan is expected to pay the full out-of-pocket cost for the Part D product. CMS’ discretion to use a variety of methods to determine the additional out-of-pocket costs. The Secretary may use one of the following methods to determine the amount of the additional out-of-pocket cost:

a formula that takes into account the costs that the provider would incur under the existing system of reimbursement and the costs of the new system;

a formula that takes into account the Medicare Unbundled Reference Case analysis cost methodology;

a formula that takes into account the Medicare Unbundled Reference Case analysis cost methodology and also takes into account the costs that the provider would incur under the existing system of reimbursement;

a formula that is based on the lowest-priced plan available in the market; or

the Secretary may use her discretion to take into account any additional cost related to the model.

In addition, the Model includes provisions that would increase the bonus percentage for a Part D plan to 90 percent for 2020 and would increase the bonus percentage for 2021 to 100 percent. These provisions are in place until December 31, 2021. Applicants must be enrolled in the Model for a minimum of one month to be eligible for the maximum bonus, and may choose to extend their enrollment until December 31, 2021. The Model will be renewed on December 31, 2021, and so applicants will be eligible for the maximum bonus for another 12 months.

ABCD premiered across India in Hindi, Tamil and Telugu languages.[10] The film was released in the United States on 2 June 2013.[11][12] As per the Bollywood trade website Box Office India, with around 1.50 billion viewers,[13] the film grossed 45.11 million in its first week. 827ec27edc