The Centers for Medicare & Medicaid Services late this afternoon released a proposed rule that would make programmatic and operational changes to the Medicare Advantage and prescription drug benefit programs for contract year 2020. Specifically, the rule proposes changes in policies to implement provisions of the Bipartisan Budget Act of 2018 related to expanded coverage of telehealth services through the MA program, as well as better integration of coverage for Medicare and Medicaid dual-eligible beneficiaries. The rule also proposes updates to the MA and Part D Quality Rating System, as well as to certain program integrity provisions. CMS estimates that, if finalized, the rule would result in $4.5 billion in savings over 10 years, largely due to recovery of overpayments to MA plans. The rule will be published in the Nov. 1 Federal Register, with comments accepted for 60 days. Watch for a Special Bulletin with further details.

Related News Articles

Headline
Over 1,750 Medicare Part D prescription drug plans and Medicare Advantage plans with prescription drug coverage have applied to offer lower insulin costs…
Headline
The Centers for Medicare & Medicaid Services April 6 finalized updates and changes to its Medicare Advantage and Part D payment methodologies for calendar…
Headline
The Centers for Medicare & Medicaid Services should develop prior authorization measures for the Medicare Advantage Star Ratings Program to minimize care…
Headline
The Centers for Medicare & Medicaid Services today proposed changes to the Medicare Advantage and Medicare Part D programs, including implementing various…
Headline
The Centers for Medicare & Medicaid Services yesterday announced proposed changes to the risk adjustment model for Medicare Advantage organizations and…
Headline
Medicare Advantage organizations received $6.7 billion in risk adjustment payments in 2017 for diagnoses that were not supported by the medical record,…