The Centers for Medicare & Medicaid Services (CMS) has issued Part II of its 2020 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part D Payment Policies and Draft Call letter. CMS proposes a 1.59 percent increase to baseline Medicare Advantage payment rates for 2020.
Part II of the advance notice also includes a number of proposals to address the opioid epidemic, including:
- Offering new flexibilities for plans to offer targeted benefits and cost-sharing reductions for patients with chronic pain or who are undergoing addiction treatment
- Encouraging Part D sponsors to provide lower cost-sharing for opioid-reversal agents, such as naloxone
- Updating the star rating methodology to include new opioid-related measures
CMS also proposes additional flexibility — as required by the Bipartisan Budget Act of 2018 — for MA plans to offer supplemental health benefits for certain enrollee populations, such as reductions from fee-for-service Medicare-equivalent cost sharing, and primarily non-health related supplemental benefits, such as transportation for non-medical needs, home-delivered meals, food and produce.
CMS previously issued Part I of the Advance Notice, which includes updates to the risk adjustment model for capitated payments for MA plans. Comments on both Part I and Part II are due March 1. Additional information is available in a CMS fact sheet.