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- Regan Pennypacker on Latest Audit Enforcement Actions Issued by CMS
- Kathleen Chapman on 2019 Medicare Advantage Rate Announcement & Call Letter
- Michelle Juhanson on Latest Audit Enforcement Actions Issued by CMS
- Alan Mittermaier on MA and Part D Proposed Rule Increases Plan Flexibility, Reduces Regulatory Burden
- Sharon Willliams on A New Source of Capital for Star Ratings and Clinical Innovations
Topic: Star Ratings
On February 1, 2018, the Centers for Medicare & Medicaid Services (CMS) released its 2019 Advance Rate Notice (Part II) and Draft Call Letter. CMS estimates an expected increase of 1.84% to payments in 2019. CMS says its estimates do not reflect underlying coding trend, which it expects to increase risk scores by 3.1% in 2019.
As 2018 and Year 2 of the chaotic Trump Administration kick off, trying to predict what will happen in Medicare, Medicaid, and the Affordable Care Act is as challenging as ever. It’s a midterm election year with terrible headwinds for the GOP, so the legislative calendar is abbreviated, and partisan rancor will peak. That makes it less likely Republicans will get to do much damage but also more likely they will try to serve up red meat for their base, like a return to “repeal and replace.” Congressional leaders, fresh off their billionaire bailout tax bill, are already talking about taking up “reform” (aka cuts) of Medicare and Medicaid and other social welfare programs. The only thing that is certain is 2018 will be another battleground year for government health programs.
With comments on the Medicare Advantage (MA) and Prescription Drug Benefit Program (Part D) Proposed Rule for 2019 due by January 16, 2018, we’ve received numerous requests for help distilling the Stars elements from the Centers for Medicare & Medicaid Services (CMS’) 713 pages of proposed regulations. Yep, we’ve read all 713 pages, and CMS is seeking feedback on numerous potential adjustments to the Star Ratings programs in the coming years. CMS has, and continues to, demonstrate its willingness to consider plan feedback on proposed changes, and plans should seize this opportunity to be “on the record” so CMS can make well-informed decisions as it adjusts the program in the coming years.