CMS proposes MA, Part D payment and policy changes for 2018

The Centers for Medicare & Medicaid Services yesterday announced proposed changes to the Medicare Advantage and Part D prescription drug programs for calendar year 2018, which would increase payment rates by a net 0.25%. When combined with expected growth in plan risk scores, CMS anticipates the MA plans and Part D sponsors will see an average revenue increase of 2.75%. CMS proposes to use the same proportion of Risk Adjustment Processing System and encounter data for purposes of calculating risk adjustment as was used in 2017 and apply the minimum coding intensity adjustment allowable under federal law. CMS also proposes several changes to the Medicare Advantage Star Ratings program, the service category cost-sharing requirements, and the drug utilization review controls. CMS will accept comments on the 2018 Advance Notice and Draft Call Letter through March 3, and expects to publish a final rate announcement and call letter on April 3.