Here are 10 Medicare Advantage updates Becker’s has reported since Feb.2.
- AHIP is opposed to some of CMS’ proposed changes to the Medicare Advantage star ratings program. In a comment letter submitted to CMS Feb. 13, the association said CMS’ proposed changes would not improve plan quality but could reduce benefits or increase premiums.
- Provider groups applauded CMS’ proposed rule overhauling prior authorization in Medicare Advantage. A group of 118 medical societies, led by the American Medical Association, voiced strong support for the reforms in a comment letter submitted to CMS Feb. 13.
- Medicare beneficiaries who enroll in a Medicare Advantage plan may need less retirement savings to cover their healthcare costs, an analysis published by the Employee Benefits Research Institute found.
- According to end-of-year earnings reports, UnitedHealthcare has the most Medicare Advantage members among large payers at 7.1 million.
- CMS must stop harmful care denials in Medicare Advantage, Louisiana Hospital Association President Paul Salles wrote in a viewpoint for Becker’s.
- Payer executives are still taking stock of tougher Medicare Advantage auditing standards CMS unveiled Jan. 31. On fourth-quarter earnings calls, executives told their investors they are evaluating next steps and awaiting more information from CMS.
- CMS is lacking data on how Medicare Advantage supplemental benefits are used, according to a report from the U.S. Government Accountability Office.
- More scrutiny is expected for providers who serve patients covered by Medicare Advantage. CMS said it will implement stricter auditing practices around MA plans, meaning that physicians and providers who serve Medicare Advantage enrollees are more likely to see increased oversight of how they document a patient’s medical conditions.
- Elevance Health has the highest number of prior authorization requests per Medicare Advantage member, while CVS and Kaiser Permanente have the highest rate of denials in 2021, according to an analysis from Kaiser Family Foundation.
- CMS is expecting a small revenue bump of 1.03 percent on average for Medicare Advantage and Part D plans in 2024 as part of a slate of potential risk adjustment and star ratings changes that has some industry leaders concerned.
