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From Health Law Daily, June 22, 2015

MA and Part D stakeholders may get more time to comment on annual payment and policy changes

By Harold M. Bishop, J.D.

On June 17, 2015, the House of Representatives passed H.R.2507 by voice vote. The Increasing Regulatory Fairness Act of 2015, starting in 2017, increases from 45 to 60 days the timeframe between CMS’ release of proposed annual payment rate and policy change notices associated with the Medicare Advantage (MA) and Part D programs and their finalization, and also provides a minimum of 30 days for stakeholders to comment on these notices starting in 2017. The bill was received in the Senate on June 18, 2015 and referred to the Committee on Finance.

Rationale for change. The CMS annual Call Letter and Rate Notice has substantially increased from less than 20 pages in 2006 to well over a hundred pages and is becoming increasingly complex each year. To ensure fairness for all stakeholders, the Ways and Means Committee felt that legislation was needed to increase the time for interested parties to read and remark on proposals affecting the industry, stakeholders, and beneficiaries through changes in MA and Part D policy and payment rates. The Committee thought that establishing a minimum 30-day time frame for comment was reasonable.

Other changes. In addition to the timeframe changes, for 2017 and each subsequent year, before April 1 of the preceding year, H.R.2507 would require HHS to determine and announce: (1) the annual MA capitation rate for each MA payment area for the year concerned; (2) the risk and other factors to be used in adjusting such rates for monthly payments in such year; (3) the MA region-specific non-drug monthly benchmark amount for each MA region and each MA regional plan for which a bid was submitted; and (4) the major policy changes to the risk adjustment model, and the 5-star rating system, that are determined to have an economic impact.

Companies: Centers for Medicare & Medicaid Services

MainStory: TopStory FederalLegislationNews CMSNews PartCNews PartDNews

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