Commenting today on proposed changes to Medicare Advantage and Part D payment policies for calendar year 2019, AHA voiced strong support for the Centers for Medicare & Medicaid Services’ proposal to expand the types of supplemental benefits that MA plans can offer to better manage beneficiary health. "We also generally support CMS’s proposals that would allow plans to better prevent opioid misuse and addiction,” wrote AHA Executive Vice President Tom Nickels. “However, we continue to remain concerned about increasing the use of encounter data for purposes of risk adjustment.” Noting that provider data collection efforts were not designed to support MA risk-adjustment calculations, AHA encouraged CMS to reconsider the use of encounter data until issues related to data quality and provider and plan burden are addressed.

Related News Articles

Headline
The Centers for Medicare & Medicaid Services July 10 issued a proposed rule that would increase Medicare hospital outpatient prospective payment system…
Headline
The Healthcare Equality Network July 3 sent a letter to the Centers for Medicare & Medicaid Services, expressing concerns about claims denials by…
Headline
The Department of Health and Human Services’ Office of Inspector General last week announced its intent to investigate Medicare Advantage Organizations’ prior…
Headline
In a letter submitted July 2 to the Centers for Medicare & Medicaid Services on guidance for the Medicare Drug Price Negotiation Program, the AHA expressed…
Headline
The Centers for Medicare & Medicaid Services June 28 released a proposed rule on mitigating the impact of significant, anomalous and highly suspect (SAHS)…
Headline
The Department of Health and Human Services June 26 announced beneficiary coinsurance reductions for 64 prescription drugs available through Medicare Part B.…