Morning Briefing
Summaries of health policy coverage from major news organizations
CMS Signals That Medicare Advantage Payments Will Decline In 2024
Stat: Biden Administration Floats Major 2024 Pay Cut For Medicare Advantage Plans
Medicare Advantage insurers could face an average 2.3% cut to baseline payments in 2024, the Biden administration said Wednesday. If the proposal stands, it would be a net cut of more than $3 billion to the industry. The major reason behind the proposed pay cut: Medicare officials want to update data and coding systems that are used to explain the health conditions of an insurance company’s enrollees. Under that new system, insurers would not get paid as much for members with certain diagnoses. (Herman, 2/1)
Modern Healthcare: CMS Issues Medicare Advantage, Part D 2024 Payment Policy Notice
Medicare Advantage rates will rise by 2.09% next year, in line with expectations, the Centers for Medicare and Medicaid Services announced in a notice published Wednesday. The advance notice includes a number of provisions, such as revisions to Medicare Advantage risk-adjustment and changes to the star ratings programs for Medicare Advantage and Medicare Part D. CMS also laid out its plan to implement provisions from the Inflation Reduction Act of 2022. (Berryman, 2/1)
Healthcare Finance News: Medicare Advantage Plans Get A Proposed 1.03% Payment Increase In 2024
Medicare Advantage plans are expected to receive a 1.03% increase in revenue under the 2024 Advance Notice for the Medicare Advantage and Part D Prescription Drug Programs released by the Centers for Medicare and Medicaid Services on Wednesday. CMS is proposing technical updates to the MA risk adjustment model by fully transitioning to the Internal Classification of Diseases from ICD-9 to ICD-10. The latter has been in use since 2015. It also updates underlying fee-for-service data years from 2014 diagnoses and 2015 expenditures to 2018 diagnoses and 2019 expenditures. (Morse, 2/1)
In updates on the debt ceiling talks —
USA Today: How Medicare And Social Security Benefits Factor Into The Kevin McCarthy Debt Ceiling Fight
Speaker Kevin McCarthy left his first White House visit with confidence that he and President Joe Biden could negotiate a spending deal, but the real test may come in negotiations with his own Republican conference. McCarthy, who had to bargain with hardline conservatives to win his speaker bid after 15 rounds of voting, leads a fractious caucus where some members are willing to gamble with the nation's credit score and global economy to try and get the federal spending cuts they want. But what those cuts are, nobody seems to know. (Woodall, 2/1)
Kansas City Star: Hawley Wants To Shield Social Security, Medicare From Debt Ceiling Talks. Experts Say It Won’t Work
Sen. Josh Hawley introduced a bill Wednesday to prevent Congress from using Social Security and Medicare as a tool in negotiations over the debt ceiling, as some members of his party have talked about making changes to the programs. “These are key programs that, frankly, every American relies on,” said Hawley, a Missouri Republican. “They pay into it and every American expects when they retire, that they will be able to collect that Social Security benefit they paid into and also the Medicare health care benefit that they had paid into.” (Desrochers, 2/1)
In other Medicare news —
Bloomberg: Medicare Advantage Health Insurer Humana Seeks Details On Payment Clawbacks
Humana Inc. said it needs more details to gauge the impact of a new Medicare policy that threatens to claw back billions from health insurers, but investors have decided it’s not nearly as bad as they feared. (Tozzi, 2/1)
Forbes: Humana Sees Growth Of ‘At Least’ 625,000 Medicare Advantage Members This Year
Humana said its individual enrollment in Medicare Advantage plans would jump by “at least 625,000” for 2023 in what is becoming a banner year for the popular privatized health insurance for U.S. seniors. The projection for Medicare Advantage growth was included in Humana’s fourth quarter earnings report released Wednesday that included a $15 million loss thanks in part to costs of investments made last year to improve its health plan operations. Revenues rose to $22.4 billion in the fourth quarter on Medicare Advantage growth and higher premiums compared to $21 billion in the year-ago period. (Japsen, 2/1)
Nerdwallet and AP: What’s New For Medicare In 2023?
A new year means changes to Medicare, including updated premiums and deductibles and sometimes big policy moves. In 2023, there’s a little of everything: Some costs have gone down, others have increased, and there are some notable tweaks to how Medicare works. Understanding what’s new can help you get the most from your Medicare benefits. Here are some key 2023 updates, according to the Centers for Medicare & Medicaid Services. (Ashford, 2/2)
