The Centers for Medicare & Medicaid Services Friday finalized changes to the Medicare Advantage and prescription drug programs for contract year 2020. Specifically, the final rule implements Bipartisan Budget Act of 2018 provisions that expanded MA coverage of telehealth services, and policies to better integrate coverage for Medicare and Medicaid dual-eligible beneficiaries. The rule also includes updates to the MA and Part D Quality Rating System and to certain program integrity provisions. CMS estimates the final rule will result in $4.5 billion in savings over 10 years, largely due to recovery of overpayments to MA plans. CMS did not finalize its proposed MA risk adjustment data validation provisions, which it intends to address in a future final rule.

Headline
Members of Congress and hospital and health system leaders today gathered for a briefing in Washington, D.C., to discuss how payment delays in Medicare…
Headline
The Centers for Medicare & Medicaid Services May 28 issued a final rule making changes to the Increasing Organ Transplant Access Model beginning July 1.…
Perspective
Public
Approximately 35 million Americans are enrolled in Medicare Advantage plans in 2026, and that number is expected to grow to about 45 million MA enrollees by…
Headline
The Centers for Medicare & Medicaid Services has released details on downloading its upcoming fiscal year 2025 Program for Evaluating Payment Patterns…
Headline
The Department of Health and Human Services Administration for Community Living has launched the first phase of its Health at Home Challenge, a competition to…
Headline
The AHA shared the following statement with the media in response to a report released May 7 by Families USA.   “This report is long on rhetoric and…