MGMA Washington Connection 04/06/2023

04/07/2023 11:21 AM | Rebekah Francis (Administrator)

CMS FINALIZES MA RATE NOTICE - PHASES IN CHANGES 

Last Friday, the Centers for Medicare & Medicaid Services (CMS) released the Announcement of Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the Rate Announcement). The Rate Announcement finalized policies like making technical changes to the growth rate estimate, implementing changes to the Part D drug program from the Inflation Reduction Act, and changes to the risk adjustment model.

MGMA advocated to pause the implementation of changes to the risk adjustment model to mitigate any potential unintended consequences impacting beneficiary access to care and value-based care initiatives critical to the success of medical group practices. In response to the concerns of MGMA and other stakeholders, CMS announced that the changes to the risk adjustment model will be phased in over three years rather than all at once. MGMA will continue to monitor the potential impact that these changes will have on group practices.

MEDICARE BOARD OF TRUSTEES RELEASE 2023 REPORT

The Medicare Board of Trustees has released its 2023 report, projecting that the Hospital Insurance Trust Fund would only be able to pay 100% of total scheduled benefits until 2031. The Board had previously estimated that the program would become insolvent three years earlier. The report also outlines projections showing that steep increases in Medicare costs will lead to lower relative reimbursement rates for provider groups. Compounding these concerns, it's also been noted that physicians are slated for payment reductions in future years and that the updates to physician payment in the law do not tie reimbursement to underlying economic conditions like inflation.

MGMA Government Affairs will continue to advocate for policy solutions that will ensure reimbursement rates reflect the true costs of delivering care.

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