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<div>In a letter to agency commissioners Wednesday, New York state Budget Director Blake Washington Wednesday said budget requests should not exceed what was approved in this year's $229 billion budget. This is what's known as the annual "call letter" outlining the governor's priorities and any fiscal constraints.</div><div></div><div></div><div>APRIL 4, 2006 -- The Centers for Medicare and Medicaid Services issued bidding instructions Tuesday urging private plans in Medicare to simplify their offerings for 2007. However, the CMS "call letters" instructing prescription drug and managed care plans on preparing their bids for next year do not formally standardize those offerings, a step urged by some congressional Democrats. </div><div></div><div></div><div></div><div>CMS said it wants "clearly understandable" options and that plans should compete by making it easier for beneficiaries to make comparisons. The agency said "distinct preferences" are emerging among beneficiaries for certain design features in the Medicare prescription drug benefit and that plans should focus their competitive energies on offering alternatives in those areas.</div><div></div><div></div><div></div><div>CMS wants alternatives such as deductibles versus no deductibles for drug coverage and the use of fixed-dollar co-payments for prescriptions versus "co-insurance," in which out-of-pocket costs are a percentage of the cost of the prescription. Other alternatives should include coverage versus non-coverage in the "doughnut hole," the portion of the standard drug benefit in which beneficiaries must pay 100 percent of prescription costs; a range of premium charges; and tighter versus broader formularies of covered drugs.</div><div></div><div></div><div></div><div>Bidders should make sure that differences in plans offered "can be reasonably understood," said the CMS call letter for "PDPs," the prescription-drug-only plans offered in traditional Medicare.</div><div></div><div></div><div></div><div>Two Is Enough, Mostly</div><div></div><div>Consistent with the proposed version of the call letter, CMS said that in general it wants a PDP sponsor to offer no more than two types of drug plans.</div><div></div><div></div><div></div><div>"In general, we expect that more than two bids from a sponsoring organization would not provide meaningful variation, unless one of the bids is an enhanced alternative plan that provides coverage in the coverage gap," the letter said. </div><div></div><div></div><div></div><div>The document also addresses a number of problems that fouled the start of the drug benefit for some beneficiaries and pharmacists, such as long telephone wait times for assistance and delayed updates of enrollment data.</div><div></div><div></div><div></div><div>"CMS expects sponsors to develop and maintain information systems that accurately process updated enrollment information at least weekly," the letter says. Call centers operated by drug plans to handle questions by current and prospective enrollees must answer 80 percent of calls within 30 seconds. "Abandoned" calls in which beneficiaries on hold hang up must not exceed 5 percent of all beneficiary calls.</div><div></div><div></div><div></div><div>Those new timeliness standards also apply to toll-free call centers that plans must operate to answer inquiries from pharmacists and doctors or nurses about a beneficiary's coverage. The call center must be open when the pharmacies participating in a plan are open, even if that's 24 hours a day. CMS is going to be releasing weekly reports on call center performance, the agency said. </div><div></div><div></div><div></div><div>The call letter also advises plans that they must have a "one-stop" area on their Web sites providing information on how beneficiaries can appeal decisions not to cover drugs.</div><div></div><div></div><div></div><div>A separate CMS call letter to managed care plans on the Medicare Advantage side of Medicare also aims to clear up beneficiary confusion. In some cases, "beneficiaries are unable to make meaningful distinctions between the various plans offered by a sponsor," the letter said. Sponsors must eliminate plans "that are substantially duplicative in terms of cost sharing, provider networks and benefit design," including drug coverage offered by the plans, the letter said. </div><div></div><div></div><div></div><div>CMS also said that, in general, it will no longer be possible to market a managed care plan as having a "zero premium" for Medicare Part B, which covers physician services and certain other forms of care outside the hospital. The agency noted that in 2007 higher-income beneficiaries will pay higher premiums for Part B than other beneficiaries. Since an MA plan must offer uniform benefits, the zero premium claim could not be made in marketing, but plans can tout premium rebates, the letter explains.</div><div></div><div></div><div></div><div>Consumers Union has expressed strong support for limiting the number of drug benefit designs. "The current proliferation of plans, many with minor differences, has simply led to confusion and predictable paralysis of choice among many beneficiaries and their families," the publisher of Consumer Reports said in a March 1 comment on a draft version of the call letter.</div><div></div><div></div><div></div><div>It expressed support for legislation offered by Rep. Marion Berry, D-Ark. (HR 752), and Sen. Richard J. Durbin, D-Ill. (S 345), that would create a drug plan administered directly by Medicare and that would compete with private prescription drug plans in the program. The Medicare-run plan would have authority to negotiate prescription drug pricing.</div><div></div><div></div><div></div><div>Pending such legislation, "we support the concept of reducing the number of plans and, to the extent possible, grouping them according to a few broad characteristics," Consumers Union said. But "we doubt that any grouping will be enough to help consumers," the group added. </div><div></div><div></div><div></div><div>Issues such as formularies of covered drugs, tiers of varying co-payments within plans, utilization controls, and differences in grievance and appeal procedures "are simply too complex to be made understandable to the layperson."</div><div></div><div></div><div></div><div>In the Senate, Democrats Max Baucus, Mont. and Ron Wyden, Ore., have expressed interest in introducing legislation simplifying drug plan comparisons by standardizing the plans that could be offered.</div><div></div><div></div><div></div><div></div><div></div><div>tat hs call letter download 2023</div><div></div><div>Download Zip: https://t.co/Jt8j1z49on </div><div></div><div></div><div>Call letters are official notifications of upcoming events and/or educational opportunities. These call letters are posted as information is finalized and available for publishing. You may find the calendar of events (subject to change) for the entire year by clicking here.</div><div></div><div></div><div>The use of call signs as unique identifiers dates to the landline railroad telegraph system. Because there was only one telegraph line linking all railroad stations, there needed to be a way to address each one when sending a telegram. In order to save time, two-letter identifiers were adopted for this purpose. This pattern continued in radiotelegraph operation; radio companies initially assigned two-letter identifiers to coastal stations and stations on board ships at sea. These were not globally unique, so a one-letter company identifier (for instance, 'M' and two letters as a Marconi station) was later added. By 1912, the need to quickly identify stations operated by multiple companies in multiple nations required an international standard; an ITU prefix would be used to identify a country, and the rest of the call sign an individual station in that country.[1]</div><div></div><div></div><div>Merchant and naval vessels are assigned call signs by their national licensing authorities. In the case of states such as Liberia or Panama, which are flags of convenience for ship registration, call signs for larger vessels consist of the national prefix plus three letters (for example, 3LXY, and sometimes followed by a number, i.e. 3LXY2). United States merchant vessels are given call signs beginning with the letters "W" or "K" while US naval ships are assigned call signs beginning with "N". Originally, both ships and broadcast stations were assigned call signs in this series consisting of three or four letters. Ships equipped with Morse code radiotelegraphy, or life boat radio sets, Aviation ground stations, broadcast stations were given four letter call signs. Maritime coast stations on high frequency (both radiotelegraphy and radiotelephony) were assigned three letter call signs. As demand for both marine radio and broadcast call signs grew, gradually American-flagged vessels with radiotelephony only were given longer call signs with mixed letters and numbers.</div><div></div><div></div><div>Leisure craft with VHF radios may not be assigned call signs, in which case the name of the vessel is used instead. Ships in the US still wishing to have a radio license are under FCC class SA: "Ship recreational or voluntarily equipped." Those calls follow the land mobile format of the initial letter K or W followed by 1 or 2 letters followed by 3 or 4 numbers (such as KX0983 or WXX0029). U.S. Coast Guard small boats have a number that is shown on both bows (i.e. port and starboard) in which the first two digits indicate the nominal length of the boat in feet. For example, Coast Guard 47021 refers to the 21st in the series of 47-foot motor lifeboats. The call sign might be abbreviated to the final two or three numbers during operations, for example: Coast Guard zero two one.</div><div></div><div></div><div>Currently, all signs in aviation are derived from several different policies, depending upon the type of flight operation and whether or not the caller is in an aircraft or at a ground facility. In most countries, unscheduled general aviation flights identify themselves using the call sign corresponding to the aircraft's registration number (also called N-number in the U.S., or tail number). In this case, the call sign is spoken using the International Civil Aviation Organization (ICAO) phonetic alphabet. Aircraft registration numbers internationally follow the pattern of a country prefix, followed by a unique identifier made up of letters and numbers. For example, an aircraft registered as N978CP conducting a general aviation flight would use the call sign November-niner-seven-eight-Charlie-Papa. However, in the United States a pilot of an aircraft would normally omit saying November, and instead use the name of the aircraft manufacturer or the specific model. At times, general aviation pilots might omit additional preceding numbers and use only the last three numbers and letters. This is especially true at uncontrolled fields (those without control towers) when reporting traffic pattern positions or at towered airports after establishing two-way communication with the tower controller. For example, Skyhawk eight-Charlie-Papa, left base. In commercial aviation, the callsign is usually the ICAO Flight number. For example, Delta Airlines Flight 744 would have the flight number DL744 and the callsign would be Delta 744.</div><div></div><div> 8d45195817</div>
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