Pharmacy Blog
Part I of the 2022 Medicare Advantage and Part D Advance Notice was posted by CMS to give plans advance notice of anticipated changes to payments. In order to provide Medicare Advantage organizations and Part D sponsors additional time to evaluate this information when preparing their bids for 2022, this notice is being issued three months earlier than usual.
The Medicare Advantage program is more robust than ever, and that should be your primary lesson from this batch of rulemaking. Despite the Affordable Care Act’s reduction in MA plan reimbursements, which brought their payment into line with standard Medicare, growth has continued to be robust.
COVID-19 Epidemic
The Trump Administration and CMS’s main priority in light of the COVID-19 public health emergency (PHE) is the health and safety of American patients and the workforce of healthcare providers. CMS is working nonstop to provide the American healthcare system with the greatest adaptability possible in order to handle the COVID-19 pandemic.
The CY 2022 Advance Notice exemplifies CMS’s commitment to putting key policies into effect in order to guarantee consistent and steady payments throughout the health care system and the provision of care where it is required.
Although CMS’s response to the COVID-19 outbreak is not listed in the Advance Notice, MA organizations, PACE organizations, and Part D sponsors can review a summary of CMS’ response to the outbreak at CMS Flexibilities to fight COVID-19.
Due to similar concerns over the potential associated with the efforts to collect and submit the survey data, CMS is eliminating the need for Medicare health and drug plans to submit their 2020 Consumer Assessment of Healthcare Providers & Systems (CAHPS) survey data. Any data gathered from the CAHPS survey may be used by Part C and D plans for internal quality improvement initiatives.
The Health Outcomes Survey for this year was supposed to be conducted from April to July 2020 by NCQA and CMS in collaboration as part of the HEDIS data collection process. The administration of this survey has been rescheduled for late summer, and CMS will keep an eye on the situation to see whether any other changes are necessary.
Part C and Part D Medicare Advantage Star Ratings 2022 Star Rating
Calculations There is no need to worry about data collection for the 2020 performance period because CMS anticipates Medicare Advantage contracts to submit HEDIS data in June 2021 and Medicare Advantage and Prescription Drug Plan (Part D) contracts to conduct the CAHPS survey in 2021 as usual.
To address concerns about overall performance in 2020, we are delaying the implementation of the 5-percentage point cap by one year, from January 1, 2020 to January 1, 2021. This will allow cut points for the 2022 Star Ratings to fluctuate by more than five percentage points in the event that the outbreak causes a decline in overall national performance.