CMS Issues Early Release of MA Advance Notice

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Original story posted on: September 17, 2020

The move contrasts with shorter timelines associated with the releases of the IPPS, OPPS rules.

In an apparent effort to make providers’ lives a little easier, federal officials earlier this week issued Part I of the 2022 Medicare Advantage (MA) Advance Notice of proposed payment changes.

“This announcement of Medicare Advantage and Part D payment methodologies is being made approximately three months earlier than usual to provide Medicare Advantage organizations and Part D sponsors more time to take this information into consideration as they prepare their bids for 2022,” the Centers for Medicare & Medicaid Services (CMS) said in a press release. “The earlier release will help Medicare Advantage and Part D plans to better address estimating 2022 plan costs, in light of the uncertainty associated with the COVID-19 pandemic.”

CMS updates the methodology used to calculate payments made to MA and Part D plans through the agency’s Advance Notice and Rate Announcement process. Part I includes information about Medicare Advantage risk adjustment for 2022, with a 60-day comment period expiring in November.

Other changes to payment methodologies for 2022 that are typically contained in the Advance Notice Part II only require a 30-day comment period, and will be released at a later time, CMS noted. The MA and Part D payment policies for 2022, outlined in both Part I and Part II of the Advance Notice, will be finalized in the 2022 Rate Announcement – published no later than April 5, 2021.

The move contrasts with tighter CMS publication deadlines seen during recent months – for example, when the agency released the Changes to Hospital Outpatient Prospective Payment System (OPPS) for the 2021 calendar year (CY) back in August, with comments due by Oct. 5, CMS also noted that it was waiving the 60-day publication requirement for the Final Rule, instead replacing it with a 30-day notification. In other words, although the final rule will become effective Jan. 1, 2021, it may not be published until Dec. 1, instead of the typical Nov. 1 target date.

A similar announcement coincided with the Inpatient Prospective Payment System (IPPS) Final Rule for the 2021 fiscal year (FY), with a 60-day publication window also reduced to 30 days.

To review a fact sheet on Part I of the 2022 Advance Notice, go online to: https://www.cms.gov/newsroom/fact-sheets/2022-medicare-advantage-advance-notice-part-i-risk-adjustment

To view Part I of the 2022 Advance Notice, go online to https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Announcements-and-Documents.html and select “2022.”

Mark Spivey

Mark Spivey is a national correspondent for RACmonitor.com, ICD10monitor.com, and Auditor Monitor who has been writing and editing material about the federal oversight of American healthcare for more than a decade. He can be reached at mcspivey@hotmail.com.

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