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CMS Releases MA Advance Notice, Policy and Technical Changes Proposed Rule

February 11, 2020

McDermott+Consulting

On February 5, 2020, the Centers for Medicare and Medicaid Services (CMS) issued two documents affecting the Medicare Advantage (MA) program:

  • The Medicare and Medicaid Programs: Contract Year 2021 and 2022 Policy and Technical Changes to the MA Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly Proposed Rule, which codifies exiting CMS MA policies and proposes policy changes in several key areas;
  • The Advance Notice Part II, the annual guidance that proposes payment rates for plans (Part I was released January 6, 2020).

Comments on the Policy and Technical Changes Proposed Rule are due April 6, 2020. Comments on the Advance Notice Parts I and II are due March 6, 2020. The final rate announcement is expected by April 6, 2020.

With the changes outlined in these new proposals, CMS expects an average change in plan revenue of 0.93% (compared to 2020’s proposed increase of 1.59% and a final increase of 2.53%). Other proposed changes include permitting end-stage renal disease patients to enroll in MA plans, loosening some network adequacy requirements and allowing MA plans to establish a new preferred specialty tier in Part D plans.

A summary is available here.

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For more information visit the McDermottPlus Payment Innovation Resource Center or contact Mara McDermott at 202-204-1462 or mmcdermott@mcdermottplus.com.

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