31 January 2019 CMS releases proposed Medicare Advantage (MA) payment rates for 2020 and proposed payment policies for MA and Part D plans CMS proposes increasing 2020 MA rates by 1.59%, providing more leeway to offer benefits for the chronically ill, and adding opioid controls for Medicare plans. On January 30, the Centers for Medicare & Medicaid Services (CMS) released the second part of their 2020 Medicare Advantage (MA) Advance Notice, proposing to increase baseline MA payment rates for 2020 by 1.59%. The rate increase is well below the 3.4% rate hike plans received in 2019. Also published on the same day was the agency's 2020 Draft Call letter, which would permit MA plans to provide additional services to certain patients who qualify as chronically ill, allowing for the coverage of services such as transportation and home-delivered meals or groceries. CMS is also encouraging MA plans to adopt 2020 benefit designs that promote non-opioid therapies and alternative treatments such as peer support services, cognitive behavioral therapy, and therapeutic massage if advised by a doctor. CMS makes other suggestions to Part D sponsors, such as providing overdose treatments at lower cost-sharing and co-prescribing naloxone with opioids for patients that are deemed high-risk. Additionally, the agency said that it would not approve benefit designs that discouraged enrollment by beneficiaries that need medication-assisted treatment for addiction. In the first part of the Advance Notice, released in December, CMS proposed moving ahead with plans to adjust payments to reflect the total number of conditions each patient has, view each condition individually in the risk adjustment model, and increase the amount of encounter data used to determine risk scores. All comments on the Advance Notices — including Part I — and Draft Call Letter must be submitted by March 1, 2019. The final 2020 Rate Announcement will be published by Monday, April 1, 2019.
Document ID: 2019-0266 | |||||||
