The Centers for Medicare & Medicaid Services yesterday finalized its policy and payment updates for Medicare Advantage and Part D plans for calendar year 2020. The rate announcement and call letter finalizes proposed changes to the risk-adjustment model for aged and disabled beneficiaries enrolled in MA Part C plans beginning in CY 2020, and targeted benefits and cost-sharing reductions for patients with chronic pain or undergoing addiction treatment. Among other provisions, CMS provides guidance on new supplemental benefits for the chronically ill, such as meals or transportation for non-medical needs; and encourages Part D plans to provide lower cost sharing for opioid-reversal agents and advance opioid-related measures through the Star Ratings development process. The agency expects MA plans and Part D sponsors to see an average revenue increase of 2.53 percent under the final changes, excluding an average 3.3 percent increase in risk scores.

Headline
A blog by Noah Isserman, AHA director of health insurance and coverage policy, explains why a recent analysis by the Medicare Payment Advisory Commission…
Blog
Public
Medicare Advantage now covers more than half of eligible Medicare beneficiaries, making its impact on hospitals, health systems and patients impossible to…
Headline
The Department of Health and Human Services and the Centers for Medicare & Medicaid Services released a proposed rule June 12 seeking to codify the…
Headline
The Medicare Payment Advisory Commission June 15 released its June report to Congress that estimated the association between Medicare Advantage enrollment and…
Headline
The Centers for Medicare & Medicaid Services June 12 issued a final rule revising how the agency conducts oversight of accrediting organizations that…
Headline
The Department of Health and Human Services Office of Inspector General June 11 released two reports on high rates of coverage denials by Medicare Advantage…