The Centers for Medicare & Medicaid Services proposes to fully phase in its new risk adjustment model for Medicare Advantage plans in calendar year 2022, as required by the 21st Century Cures Act, the agency announced yesterday.

CMS this year began phasing in the Hierarchical Condition Categories model, used to calculate risk scores that adjust capitated payments for aged and disabled beneficiaries in MA plans and certain demonstrations based on diagnoses identified from medical encounter data.

CMS released the 2022 advance notice on MA risk adjustment about three months early to give plans more time to prepare bids, citing uncertainty associated with the COVID-19 pandemic. The agency will accept comments on the notice until 6 p.m. ET on Nov. 13. It expects to announce MA capitation rates and other Part C and D payment policies in a second notice, and release final payment policies by April 5, 2021.

Related News Articles

Headline
The AHA July 3 released the Health Care Plan Accountability Update for the second quarter of 2025. The update covers the latest developments in Medicare…
Headline
The Departments of Justice and Health and Human Services today announced the creation of the DOJ-HHS False Claims Act Working Group to combat health care fraud…
Headline
A report released June 17 by NORC at the University of Chicago, commissioned by the Coalition to Strengthen America’s Healthcare, found that patients enrolled…
Headline
The Centers for Medicare and Medicaid Services May 30 released a notice requesting comments on a proposed Medicare Advantage service level data collection…
Headline
The Government Accountability Office May 29 released a report recommending the Centers for Medicare & Medicaid Services target behavioral health services…
Headline
The Centers for Medicare & Medicaid Services May 21 announced it will immediately begin annual audits of all Medicare Advantage plans and work to clear a…