CMS proposes changes to MA, prescription drug programs

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.