Advance Notice of 2011 MA/Part D Payments
The Centers for Medicare & Medicaid Services (CMS) has issued its “Advance Notice” of changes to payment methodologies for Medicare Advantage (MA) organizations and Medicare Part D prescription drug plans for calendar year 2011. This year CMS is combining the Advance Notice with the annual “Call Letter” to health plans outlining upcoming non-payment policy changes. Among other thing, the Advance Notice includes: a preliminary estimate of a 1.38% change in the national per capita MA growth percentage; changes in risk adjustment payment methodologies; a 3.41% risk adjustment to reflect differences in coding patterns between MA plans and fee-for-service providers; and an update to the standard Part D benefit parameters. Other issues addressed in the Call Letter include practices to curb waste of unused drugs, reassignment, release of data, and drug coverage for beneficiaries with ESRD. Comments will be accepted until March 5, 2010.
