The Centers for Medicare & Medicaid Services will accept comments through March 1 at 6 p.m. ET on its advance notice of proposed changes to Medicare Advantage plan capitation rates and Part C and Part D payment policies for calendar year 2025, which the agency estimates will increase MA plan revenues by an average 3.70%. This amounts to a $16 billion increase in overall payments, but represents a -0.16% reduction in the 2025 benchmark rate compared to current policy. The notice proposes updating the Part C risk adjustment model through a phased approach to reflect ICD-10 condition categories, 2018 fee-for-service diagnoses and 2019 FFS expenditures; and Part C and Part D Star Ratings to reflect the latest regulations. It also describes changes and additions to the standard Part D drug benefit under the Inflation Reduction Act of 2022. CMS expects to publish the final 2025 rate announcement by April 1.

Related News Articles

Headline
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
The AHA Oct. 23 recommended changes to the Centers for Medicare & Medicaid Services’ Wasteful and Inappropriate Services Reduction model to address…
Headline
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 began Oct. 15 and runs through Dec. 7. During the annual enrollment period, Medicare-eligible individuals can check their…
Headline
The AHA Oct. 3 responded to the Medicare Payment Advisory Commission’s recent analysis on the financial impacts of Medicare Advantage enrollment growth on…
Perspective
Public
“Trust but verify” is a phrase often associated with President Reagan and the need to ensure that treaties enacted with the Soviet Union were being upheld.…