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.

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