Medicare Advantage rates will rise by 2.09% next year, in line with expectations, the Centers for Medicare and Medicaid Services announced in a notice published Wednesday.
The advance notice includes a number of provisions, such as revisions to Medicare Advantage risk-adjustment and changes to the star ratings programs for Medicare Advantage and Medicare Part D. CMS also laid out its plan to implement provisions from the Inflation Reduction Act of 2022.
The law eliminates cost-sharing under Part D when beneficiaries reach the “catastrophic” threshold for their pharmaceutical expenses, which kicks in at $7,400 this year. The statute also expands eligibility for low-income Part D subsidies. In addition, the Inflation Reduction Act excludes vaccination and insulin costs from plan deductibles, caps insulin costs at $35 a month, and limits base premium increases to 6% a year.
CMS described these pending policies as part of its broader regulatory agenda for Medicare Advantage. The agency issued a proposed rule in December to toughen Medicare Advantage marketing oversight and modify the star ratings program. On Monday, CMS published a final rule updating the Medicare Risk Adjustment Data Validation with an aim toward recapturing overpayments.
“The commonsense proposals in the advance notice, coupled with the proposals in the MA and Part D rule released in December, ensure these important programs continue to meet the healthcare needs of all beneficiaries while improving the quality and long-term stability of the Medicare program,” CMS Deputy Administrator and Center for Medicare Director Dr. Meena Seshamani said in a news release.
The rate update for 2024, combined with other recent CMS actions, will be challenging for insurers, the industry group AHIP contended in a news release Wednesday. “We are concerned with the potential adverse impact of the rate notice on seniors and people with disabilities, especially when taken together with the final risk adjustment data validation (RADV) rule and other policy changes proposed for next year, AHIP President and CEO Matt Eyles said in the news release. "We will carefully review and analyze the details of the proposed notice and provide comprehensive, constructive feedback to CMS during the comment period to reinforce that CMS should not finalize payment policies that increase costs and/or reduce benefits for MA enrollees, especially when healthcare cost and inflationary pressures remain high.
CMS will accepting comments on the notice until March 3 and plans to publish a final rate by April 3.
