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.

Related News Articles

Headline
The American Society for Health Care Engineering July 28 announced the recipients of its annual member awards during the 2025 Health Care Facilities Innovation…
Headline
Five pediatric flu deaths were reported to the Centers for Disease Control and Prevention last week, pushing the total to 266 for the 2024-2025 flu season,…
Headline
The Substance Abuse and Mental Health Services Administration July 28 released its latest national survey on drug use and mental health. Among the findings,…
Chairperson's File
Public
The recently enacted One Big Beautiful Bill Act will bring big changes to health care. AHA President and CEO Rick Pollack joined me for a Leadership Dialogue…
Headline
The Senate Health, Education, Labor and Pensions Committee yesterday voted 12-11 along party lines to recommend the confirmation of Brian Christine, M.D., to…
Headline
A report from AARP and the National Alliance for Caregiving released today found nearly 1 in 4 U.S. adults (63 million) are caring for an adult or child…