HHS: Medicare Advantage audits, risk adjustment changes are not funding cuts

Medicare Advantage audits are "unequivocally not cuts" in funding, HHS says. 

In a Feb. 17 news release, the agency responded to claims from insurers that newly proposed auditing standards and changes to risk adjustment payments equate to a cut in funding for Medicare Advantage. 

Recouping overpayments to MA plans will not lead to reduced premiums or benefits for MA beneficiaries, HHS said. 

Industry groups have also decried a slate of potential risk adjustment and star ratings changes CMS proposed Feb. 2. 

Industry groups have said the proposal amounts to a 2.3 percent cut in funds for the program, while CMS maintains the proposal will lead to a small 1.03 percent revenue bump for MA plans. 

A study commissioned by the Better Medicare Alliance, a pro-MA group funded by insurers, found the proposed changes could reduce funding for beneficiaries by $540 a year. 

"Any claim that this administration is cutting Medicare is categorically false," HHS Secretary Xavier Becerra said in a tweet on Feb. 17. "Leave it to deep-pocketed insurance companies and industry front groups to characterize this year's proposed increase in Medicare Advantage payments as a pay cut." 

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