Medicare Advantage rates 'baffling,' lawmakers say

A group of Republican lawmakers are asking CMS to reconsider its proposed 2025 rates for Medicare Advantage. 

Forty-five lawmakers signed a letter to CMS Administrator Chiquita Brooks-LaSure expressing concerns the proposed rates could lead health plans to cut benefits for older adults and harm the viability of the program. 

"It is baffling that CMS has proposed a nearly 0.2% cut to the Medicare Advantage insurer reimbursement rate for 2025," the lawmakers wrote. 

CMS proposed cutting benchmark payments for Medicare Advantage plans by 0.2% in 2025. The agency says plans should expect to see 3.7% higher revenue overall, with an MA risk score trend of 3.86% — the average increase in risk adjustment payments year over year — offsetting risk model revisions and a projected decline in star rating bonuses. 

The insurance industry has decried the rate notice, calling it insufficient to cover rising medical costs among MA beneficiaries. Some insurers have said they will likely cut supplemental benefits for beneficiaries to offset decreasing benchmark payments. 

The lawmakers wrote they are concerned the effective growth rate proposed by CMS does not account for the impacts of inflation and rising medical costs. 

"Above all, we believe the MA effective growth rate for 2025 should be set at a level that allows MA plans to flourish and American seniors to continue to receive the high-quality affordable healthcare coverage they have enjoyed under the MA program," the lawmakers wrote. 

CMS will publish its final rate notice on or before April 1. 

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