CMS finalizes 2020 payment changes for MA, Part D plans

Apr 02, 2019 - 03:00 PM

The Centers for Medicare & Medicaid Services yesterday finalized its policy and payment updates for Medicare Advantage and Part D plans for calendar year 2020. The rate announcement and call letter finalizes proposed changes to the risk-adjustment model for aged and disabled beneficiaries enrolled in MA Part C plans beginning in CY 2020, and targeted benefits and cost-sharing reductions for patients with chronic pain or undergoing addiction treatment. Among other provisions, CMS provides guidance on new supplemental benefits for the chronically ill, such as meals or transportation for non-medical needs; and encourages Part D plans to provide lower cost sharing for opioid-reversal agents and advance opioid-related measures through the Star Ratings development process. The agency expects MA plans and Part D sponsors to see an average revenue increase of 2.53 percent under the final changes, excluding an average 3.3 percent increase in risk scores.

Related News Articles

Headline
KFF analysis highlights limited physician access in Medicare Advantage plans
A new report from KFF reveals that Medicare Advantage enrollees had access to just 48% of the physicians available to Traditional Medicare beneficiaries in…
Headline
AHA shares concerns, recommendations with CMS on WISeR model
The AHA Oct. 23 recommended changes to the Centers for Medicare & Medicaid Services’ Wasteful and Inappropriate Services Reduction model to address…
Headline
CMS releases guide on prior authorization submissions, determinations under WISeR model  
The Centers for Medicare & Medicaid Services has released an operational guide for Medicare-enrolled providers and suppliers on the Wasteful and…
Headline
OIG says MA, Medicaid managed care plans have limited, inaccurate behavioral health provider networks 
A report by the Department of Health and Human Services Office of the Inspector General found that many Medicare Advantage and Medicaid managed care plans…
Headline
Medicare open enrollment for 2026 begins
Medicare open enrollment for 2026 began Oct. 15 and runs through Dec. 7. During the annual enrollment period, Medicare-eligible individuals can check their…
Headline
AHA encourages MedPAC to refine analysis of MA enrollment impacts on patients, providers
The AHA Oct. 3 responded to the Medicare Payment Advisory Commission’s recent analysis on the financial impacts of Medicare Advantage enrollment growth on…