CMS Eases Expected 2024 Payment Rate Cut To Medicare Advantage Insurers
Medicare Advantage providers face a 1.12% average cut in next year's reimbursement rates, the Centers for Medicare and Medicaid Services announced Friday — lower after intense industry lobbying than the 2.3% drop regulators had previously proposed. Additional changes aimed at combatting overbilling by providers will be phased in over a 3-year period.
Reuters:
US Softens Cut To Medicare Advantage 2024 Payments
The U.S. government announced on Friday a lower than expected 1.1% average cut of 2024 reimbursement rates for health insurers that offer coverage through the Medicare Advantage program, boosting shares of the market's largest players. It improved the rates it would pay insurers after pushback from the industry, which contended the government was cutting reimbursement rates by too much for them to adequately serve older people enrolled in their plans. (Aboulenein, 3/31)
Bloomberg:
Medicare Moderates Cut For Health Insurers In Final Rate
The final rate notice for 2024 will mean a 1.12% cut for Medicare plans, after stripping out the expected impact of how plans report patient illnesses. The rate is slightly more favorable than what regulators proposed two months ago, which would have meant a 2.3% cut without the adjustment for patient illnesses. When including the effect of that adjustment, Medicare says average payments to plans will increase. (Tozzi, 3/31)
The New York Times:
Medicare Delays A Full Crackdown On Private Health Plans
The Biden administration on Friday finalized new rules meant to cut down on widespread overbilling by private Medicare Advantage insurance plans, but softened the approach after intense lobbying by the industry. Regulators are still moving forward with rules that will lower payments to insurers by billions of dollars a year. But they will phase in the changes over three years, rather than all at once, and that will lessen the immediate effects. (Sanger-Katz and Abelson, 3/31)
Axios:
Medicare Advantage's Complicated Tradeoffs
A fiscal 2024 Medicare Advantage rule released on Friday aims to crack down on what experts say are inappropriate — and at times potentially fraudulent — insurer billing practices, and could force plans to decide between cutting benefits and lowering their own profits. (Owens and Goldman, 4/3)
And on fraud —
Axios:
Medicare Signals Crackdown On Hospice Fraud
Medicare administrators are cracking down on hospice fraud, releasing a proposal to require physicians who order hospice services to be enrolled in or validly opted out of Medicare in order to get paid. ... The proposal could strengthen the integrity of physician certifications for Medicare beneficiaries going into hospice services, CMS said in the rule. (Goldman, 4/3)
