CMS finalizes 2021 payment changes for MA, Part D plans

Apr 08, 2020 - 04:50 PM
medicare-advantage-part-d

The Centers for Medicare & Medicaid Services April 6 finalized updates and changes to its Medicare Advantage and Part D payment methodologies for calendar years 2021 and 2022. The final rate announcement phases in changes to the risk adjustment model required between CYs 2019 and 2022 by the 21st Century Cures Act of 2016, including CMS’ proposal to calculate 75% of the risk score for CY 2021 based on encounter data and 25% of the score based on Risk Adjustment Processing System data, among other policy changes. The agency expects MA plans and Part D sponsors to see an average revenue increase of 1.66% under the final changes, excluding an average 3.56% increase in risk scores.

In detailed comments this week, AHA expressed concern with several CMS proposals to loosen network adequacy standards.  

Related News Articles

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…
Headline
CDC adopts ACIP recommendations for COVID-19, chickenpox vaccines
The Centers for Disease Control and Prevention will update its immunization schedules for the COVID-19 and chickenpox vaccines to adopt recent recommendations…
Headline
CMS finalizes Medicare Part C Utilization Management Annual Data Submission requirements 
The Centers for Medicare & Medicaid Services Sept. 30 issued a memo, through the Health Plan Management system, finalizing the Medicare Advantage…
Headline
FDA seeks feedback on measuring AI-enabled medical device performance
The Food and Drug Administration today issued a request for public comment on a series of questions regarding current approaches to evaluating artificial…