CMS Proposes Changes to Part D and Medicare Advantage

Earlier this year, CMS proposed changes to the Medicare Advantage and Part D programs through the Advanced Notice and Draft Call Letter for 2019. This is important as Medicare Advantage enrollment grows each year. One-third of Medicare beneficiaries are now enrolled in Medicare Advantage Plans. Proposed Policies CMS notes that the proposed policies and updates for 2019 are intended to “remove barriers to innovation and foster greater transparency, flexibility, and program simplification.” CMS proposes an average rate increase of 1.84%, and factoring in plan coding practices CMS estimates a net payment increase of 4.94% for 2019.  Some of the major changes include: Health Related Supplemental Benefits– Medicare Advantage plans can offer beneficiaries supplemental benefits not otherwise covered by traditional Medicare. Previously, CMS has not allowed supplemental benefits when the primary purpose is daily maintenance.  CMS seeks to expand the scope of services or items that are primarily health related to include benefits that compensate for physical impairments, ameliorate the impact of injuries or health conditions, or reduce avoidable emergency and healthcare utilization. The agency believes this change will “allow MA plans more flexibility in offering supplemental benefits that can enhance beneficiaries’ quality of life and improve health outcomes.” CMS intends to provide detailed guidance in the future, which will be informed by ea...
Source: Policy and Medicine - Category: American Health Authors: Source Type: blogs