CMS Releases Proposed Rule on Medicare Advantage, Medicare Part D, PAC and Medicaid

The Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would implement certain provisions of the Bipartisan Budget Act (BBA) of 2018.  Specifically, the BBA allows Medicare Advantage (MA) plans to provide certain additional telehealth benefits to enrollees beginning in plan year 2020, and to treat them as basic benefits. Under this proposed rule, MA plans would be able to offer telehealth benefits beyond what is currently allowable under the traditional Medicare telehealth benefit.

Additional provisions of the proposed rule address Risk Adjustment Data Validation audits and other program integrity updates, changes to the Star Ratings System methodology and modifications to the Dual Eligible Special Needs Plans.

The text of the proposed rule is available here.

The CMS fact sheet is available here.


For more information visit the McDermottPlus Payment Innovation Resource Center or contact Mara McDermott at 202-204-1462,