CMS finalizes Medicare Advantage, Part D payment changes for CY 2024

The Centers for Medicare & Medicaid Services today finalized proposed changes to Medicare Advantage plan capitation rates and Part C and Part D payment policies for calendar year 2024, which the agency estimates will increase MA plan revenues by an average 3.32% from 2023 to 2024. The Rate Announcement finalizes technical and clinical updates to the MA risk adjustment model, which will be phased in over three years, such as transitioning the model to reflect ICD-10 condition categories; updating the model with more recent Medicare data years; and making additional revisions the agency says are designed to reduce coding variation. It also includes a technical adjustment to the calculation of indirect and direct medical education costs associated with services furnished to MA enrollees, which will be phased in over three years. In addition, the Rate Announcement updates Part C and Part D Star Ratings to reflect the latest regulations, and implements changes and additions to the standard Part D drug benefit under the Inflation Reduction Act of 2022.