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Medicare Advantage payment changes for 2022 are expected to increase revenue by 2.82%

CMS is seeking feedback on a potential COVID-19 vaccination measure in the Medicare Advantage and Part D star ratings. 

Susan Morse, Managing Editor

The Centers for Medicare and Medicaid Services has released Part II of the 2022 Medicare Advantage and Part D Advance Notice three months early to provide Medicare health and prescription drug plans more time to prepare in light of the COVID-19 pandemic. 

The proposed changes released on Sept. 14 in the Advance Notice Part I and those in the Advance Notice Part II are expected to increase plan revenue by 2.82%. 

This compares to the rate notice for 2021 in which revenue was projected to increase by less than 1%.

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For 2022, CMS is proposing to apply the 5.9% statutory minimum coding intensity adjustment to risk scores. 

CMS is soliciting input on how to improve Medicare Advantage and Part D star ratings. In particular, CMS is seeking feedback on a potential COVID-19 vaccination measure to encourage Medicare beneficiaries to receive the vaccine when one becomes available.

For 2023 and beyond, CMS is reassessing how to calculate the Medicare Advantage coding pattern and what the appropriate level of adjustment should be. 

CMS is also considering whether to propose revising the Medicare Advantage ratebook to base it on data about beneficiaries with Part A and Part B, instead of beneficiaries with Part A or Part B, as is currently the case. The agency intends to issue a request for information on this topic soon.

CMS will accept comments on both parts of the CY 2022 Advance Notice through Nov. 30, before publishing the final rate announcement by April 5, 2021.
 
WHY THIS MATTERS

The announcement is being made approximately three months earlier than usual to provide Medicare Advantage organizations and Part D sponsors more time to better estimate 2022 plan costs and to prepare bids for 2022, in light of the uncertainty associated with the COVID-19 pandemic.
 
THE LARGER TREND

CMS uses the advance notice and rate announcement process each year to adopt certain payment policies for Medicare Advantage and Part D as well as the benefit parameters for Part D plans. 

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com