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.