Magellan Rx Management Achieves Perfect CMS Audit for Medicare Part D

Rhea-AI Summary

Magellan Health, Inc. announced that its pharmacy benefit management division, Magellan Rx Management, achieved a perfect audit score from the Centers for Medicare & Medicaid Services (CMS) for its Granite Alliance Insurance Company Employer Group Waiver Plan. Conducted in September 2021, the audit evaluated program areas like Compliance Program Effectiveness and Coverage Determinations, yielding zero invalid data submissions and no corrective actions required. CEO Mostafa Kamal praised the team for this significant achievement, reinforcing their commitment to supporting Medicare beneficiaries.

Positive

• Achieved a perfect audit score from CMS.
• Zero invalid data submissions during the audit.
• No corrective actions required from the audit.

Negative

• None.

FRISCO, Texas--(BUSINESS WIRE)-- Magellan Health, Inc. today announced that Magellan Rx Management (MRx), the full-service pharmacy benefit management division of the company, received a perfect audit score from the Centers for Medicare & Medicaid Services (CMS) for its Granite Alliance Insurance Company Employer Group Waiver Plan (EGWP), a type of Medicare Prescription Drug (Part D) plan. The plan provides prescription drug benefits for eligible individuals 65 years and older and eligible individuals with disabilities.

The program audit was conducted in September 2021 and tested three main areas of the program: Compliance Program Effectiveness (CPE); Formulary and Benefit Administration (FA); Coverage; and Coverage Determinations, Appeals, and Grievances (CDAG). The results of the audit showed zero invalid data submissions, zero findings, zero observations, and zero “Corrective Action Plans Required” (CARs) or “Immediate Corrective Action Plans Required” (ICARs).

“It is truly remarkable to see zero conditions, zero observations, and a glowing review from CMS across all areas that were audited - CDAG, Formulary Administration, and Compliance Program Effectiveness,” said Mostafa Kamal, chief executive officer at Magellan Rx Management. “I’m incredibly proud of our team and their daily commitment to support the Medicare beneficiaries that our clients entrust us with, and this CMS audit result is further validation of Magellan Rx Management’s relentless pursuit of excellence.”

About Magellan Rx Management: Magellan Rx Management, a division of Magellan Health, Inc., is a next-generation pharmacy organization that is delivering meaningful solutions to the people we serve. As pioneers in specialty drug management, industry leaders in Medicaid pharmacy programs and disruptors in pharmacy benefit management, we partner with our customers and members to deliver a best-in-class healthcare experience.

About Magellan Health: Magellan Health, Inc. a is a leader in managing the fastest growing, most complex areas of health, including special populations, complete pharmacy benefits and other specialty areas of healthcare. Magellan supports innovative ways of addressing the whole health needs of members through technology, while remaining focused on the critical personal relationships that are necessary to achieve a healthy, vibrant life. Magellan's customers include health plans and other managed care organizations, employers, labor unions, various military and governmental agencies and third-party administrators. For more information, visit MagellanHealth.com.

(MGLN-GEN)

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Media: Lilly Ackley, ackleyl@magellanhealth.com, (860) 507-1923

Source: Magellan Health, Inc.