CMS proposes MA, Part D payment and policy changes for 2016

The Centers for Medicare & Medicaid Services late today announced proposed changes to the Medicare Advantage and Part D prescription drug programs for calendar year 2016, which would reduce payments by a net 0.95%. When combined with expected growth in plan risk scores due to coding, CMS said the changes would increase revenue for MA plans and Part D sponsors by an average 1.05%. Among other policy changes, CMS proposes to reiterate existing rules requiring Medicare Advantage organizations to maintain accurate provider network directories for enrollees; reduce the weight of seven measures in its star rating system to counterbalance the lack of socioeconomic adjustments; and publish information on access to preferred cost sharing pharmacies for each Part D plan offering a preferred cost sharing benefit structure. CMS will accept comments on the 2016 Advance Notice and Draft Call Letter through March 6, and expects to publish a final rate announcement and call letter on April 6.