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
The Centers for Medicare & Medicaid Services April 6 released the Medicare Advantage and Part D Rate Announcement for calendar year 2027. The rate…
Headline
The Centers for Medicare & Medicaid Services April 2 released a final rule on policy and technical changes to Medicare Advantage, the Medicare Prescription…
Headline
The Centers for Medicare & Medicaid Services March 30 announced that C2C Innovative Solutions will replace Maximus in reviewing and processing appeals of…
Headline
The Centers for Medicare & Medicaid Services is seeking comments by May 11 on its proposed revisions to data reporting requirements for Medicare Advantage…
Headline
The Medicare Payment Advisory Commission March 12 released its March 2026 report to Congress, which includes its recommended payment rates for hospital…
Headline
The Centers for Medicare & Medicaid Services March 11 issued guidance to state survey agency directors clarifying and reinforcing the roles and…