CMS finalizes changes to MA, prescription drug programs for 2020

Apr 08, 2019 - 03:56 PM
CMS Final Rule

The Centers for Medicare & Medicaid Services Friday finalized changes to the Medicare Advantage and prescription drug programs for contract year 2020. Specifically, the final rule implements Bipartisan Budget Act of 2018 provisions that expanded MA coverage of telehealth services, and policies to better integrate coverage for Medicare and Medicaid dual-eligible beneficiaries. The rule also includes updates to the MA and Part D Quality Rating System and to certain program integrity provisions. CMS estimates the final rule will result in $4.5 billion in savings over 10 years, largely due to recovery of overpayments to MA plans. CMS did not finalize its proposed MA risk adjustment data validation provisions, which it intends to address in a future final rule.

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