Centers for Medicare and Medicaid Services to release preliminary Medicare Advantage payment plan
AHIP has voiced concern over payment benchmarks and potential cuts, saying millions of seniors would be affected.
On Friday, the Centers for Medicare and Medicaid Services is expected to release its preliminary payment plan for Medicare Advantage in policies that will address growth rates, risk adjustment and the star ratings system.
America's Health Insurance Plans has been lobbying to protect the pricing, saying any cuts would affect the 17 million seniors enrolled.
Earlier this month, an estimated 360 bipartisan members of Congress sent CMS a letter urging to them to keep Medicare Advantage affordable, AHIP said.
[Also: CMS, America's Health Insurance Plans set unified healthcare quality measures]
Since 2012, under the Affordable Care Act, CMS has been implementing a new methodology to calculate Medicare Advantage payment benchmarks in each county. The cuts are likely to reduce overall program funding by about 0.5 percent in 2017, AHIP said.
AHIP said it is also concerned about a Medicare Payment Advisory Commission recommendation that diagnoses during in-home health risk assessments, that are not clinically verified by a physician or other medical professional, not be considered for calculating Medicare Advantage plan risk scores.
This proposal could reduce Medicare Advantage funding by 2 percent, AHIP said.
[Also: $7.7 billion in reinsurance payments headed to insurers for 2015 enrollment, CMS says]
Friday's proposed rate notice will kick off 45 days of feedback before the final 2017 rates are released on April 4.
Seniors would see the impact of any new payment cuts in late October 2016, when they begin enrolling in their 2017 Medicare Advantage coverage, AHIP said.
MedPAC has shown that Medicare Advantage plans have improved efficiencies to the point that on average their costs for delivering Medicare benefits are six percent below the costs of the traditional Medicare program, said AHIP, which in effect is calling upon CMS to leave the program alone.
"It's time for policymakers to stop cutting the program that continues to meet beneficiaries' health needs," AHIP said.
Twitter: @SusanJMorse
