CMS Proposes MA and Drug Plan Payment and Policy Updates.

Date posted: March 6, 2015

The Centers for Medicare & Medicaid Services (CMS) recently issued an Advance Rate Notice and draft Call Letter proposing policy and payment updates to the Medicare Advantage and Part D Prescription Drug Programs.

Proposed changes, which seek to encourage payment to providers based on quality of patient care rather than quantity, include:

  • Refining the Medicare Advantage star rating system;
  • Increasing beneficiary access to providers through accurate provider directories; and
  • Changing the Advance Rate Notice payment.

CMS is accepting comments on the proposed Advance Rate Notice and draft Call Letter until 6:00 PM Eastern Standard Time on March 6, 2015.  Comments may be submitted electronically to AdvanceNotice2016@cms.hhs.gov.  CMS will publish the 2016 Final Rate Announcement and Call Letter on April 6, 2015.

The CMS press release on the Advance Notice and draft Call Letter is available at:

http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-02-20-3.html.

The CMS Notice and Call Letter containing the proposed policies is available at:

http://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Advance2016.pdf.

The Centers for Medicare & Medicaid Services.  “CMS Proposes 2016 Payment and Policy Updates for Medicare Health and Drug Plans.”  Press Release.  20 Feb. 2015.

The Centers for Medicare & Medicaid Services; Advance Notice of Methodological Changes for Calendar Year (CY) 2016 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2016 Call Letter; Advance Notice and Call Letter (February 20, 2015).

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