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 Nov. 25 announced lower prices for 15 Medicare Part D drugs selected for the second cycle of negotiations…
Headline
The Centers for Medicare & Medicaid Services Nov. 25 issued a proposed rule for policies governing the Medicare Advantage and Part D programs for 2027. CMS…
Headline
The Centers for Medicare & Medicaid Services released an updated notice Nov. 20 on the processing of Medicare provider claims impacted by the government…
Headline
The Medicare Part A deductible for inpatient hospital services will increase by $60 in calendar year 2026 to $1,736, the Centers for Medicare & Medicaid…
Headline
The 43-day government shutdown ended last night when President Trump signed a funding bill into law, hours after the House passed the measure by a 222-209 vote…
Headline
A new report from KFF reveals that Medicare Advantage enrollees had access to just 48% of the physicians available to Traditional Medicare beneficiaries in…