Medicare Compliance & Reimbursement

Weigh in before the deadline on March 4.

If you want to offer the Centers for Medicare & Medicaid Services (CMS) your two cents on proposed Medicare Advantage (MA) and Part D payment rate changes next year, you’ve only got a few weeks.

Update: On Feb. 2, CMS released the calendar year (CY) 2023 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies. The notice shows CMS’ continued focus on health equity, quality initiatives, and cost-cutting across the MA and Part D programs, highlighting recent data that factors into its payment adjustment proposals for CY 2023.

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CMS expects a 7.98-percent increase to MA plans’ revenue for 2023, according to the fact sheet on the notice. The agency also offers insight on Part D risk adjustments, too.

Another part of the notice focuses on a plethora of requests for stakeholder input on the Star Ratings program as CMS considers attaching a “Health Equity Index” to it.

“The Health Equity Index we seek comment on would enhance the Star Ratings program, creating transparency on how Medicare Advantage plans care for our most disadvantaged beneficiaries, and providing an opportunity to encourage improvements in their care,” said CMS Deputy Administrator and Director of the Center for Medicare Meena Seshamani, MD, PhD, in a release. “We are looking for input from our community and partners on this index, which would keep with our commitment to transparency and follow our guiding principle to advance health equity.”

CMS is also asking for feedback on these MA and Part D issues, according to the notice:

• Payment changes across the various programs and initiatives;
• Geographic rate-setting for MA payments for ESRD patients in underserved populations;
• Value-based payment models’ impact on quality measures and transformative care; and
• “Updates to risk adjustment models to continue to pay appropriately for the people enrolled in MA and Part D plans.”

Interested parties must offer CMS their opinions by March 4 as the agency plans on making a final MA and Part D rate announcement for CY 2023 by April 4.

Resources: Read the CMS brief on the notice at www.cms.gov/files/document/2023-advance-notice.pdf; review the fact sheet at www.cms.gov/newsroom/fact-sheets/2023-medicare-advantage-and-part-d-advance-notice-fact-sheet; and submit your comments by March 4 at www.regulations.gov.