CMS Finalized 2017 Payment and Policy Updates for MA, Part D

Updates to Medicare Advantage and the Part D Prescription Drug program will improve programs for health plans that provide care for vulnerable enrollees. The finalized payment and policy changes for 2017 also seek to provide table payments to plans.

The final updates have incorporated feedback received during the public comment period after the policies were first proposed in February.

“We continue to strengthen Medicare Advantage and Medicare Part D, in particular for enrollees who need additional investments in their health…” Acting Administrator Andy Slavitt said in a statement. “With these polices, we will continue to see improvements in growth, affordability, benefits, and quality for millions of seniors and people living with disabilities.”

These new updates will are expected to improve the accuracy of payments to MA plans, including a new methodology that should better reflect the cost of care, and the socioeconomic and disability status of the enrollee, in addition to increasing stability for the program within Puerto Rico.

The anticipated revenue change is approximately 0.85%, not counting the typical 2.2% added in from the growth in coding acuity. This is somewhat smaller than the first estimate in the February Advance Notice due to technical updates in the risk adjustment normalization factor.

CMS policies are also being finalized for discouraging opioid overutilization.