The Centers for Medicare & Medicaid Services late today announced proposed changes to the Medicare Advantage and Part D prescription drug programs for calendar year 2016, which would reduce payments by a net 0.95%. When combined with expected growth in plan risk scores due to coding, CMS said the changes would increase revenue for MA plans and Part D sponsors by an average 1.05%. Among other policy changes, CMS proposes to reiterate existing rules requiring Medicare Advantage organizations to maintain accurate provider network directories for enrollees; reduce the weight of seven measures in its star rating system to counterbalance the lack of socioeconomic adjustments; and publish information on access to preferred cost sharing pharmacies for each Part D plan offering a preferred cost sharing benefit structure. CMS will accept comments on the 2016 Advance Notice and Draft Call Letter through March 6, and expects to publish a final rate announcement and call letter on April 6.

Related News Articles

Headline
The House July 3 voted 218-214 to pass the final version of the One Big Beautiful Bill Act (H.R. 1), which enacts many of President Trump’s legislative…
Headline
The AHA July 3 released the Health Care Plan Accountability Update for the second quarter of 2025. The update covers the latest developments in Medicare…
Headline
The Food and Drug Administration yesterday released a safety notice announcing a software patch is available to address cybersecurity vulnerabilities in…
Headline
The House has begun consideration of the Senate-passed version of the One Big Beautiful Bill Act (H.R. 1). This continues to be a fluid…
Headline
The Departments of Justice and Health and Human Services today announced the creation of the DOJ-HHS False Claims Act Working Group to combat health care fraud…
Headline
Jon Ulven, Ph.D., behavioral health psychologist and chair of adult psychology at Sanford Health, details the fragile behavioral health landscape in rural…