CHA News Article

CMS Finalizes Medicare Advantage and Part D Rates for 2017

The Centers for Medicare & Medicaid Services (CMS) has issued the attached final rate announcement for Medicare Advantage (MA) and Part D prescription drug program changes for calendar year 2017. CMS estimates the finalized policies will result in a 0.85 percent average increase in payment rates next year, down from the proposed estimated increase of 1.35 percent.

CMS finalized the proposed policy to modify its risk adjustment model to more accurately reflect reimbursement costs for dually eligible beneficiaries by using separate coefficients for partial-benefit dually eligible beneficiaries, full-benefit dually eligible beneficiaries and non-dually eligible beneficiaries. CMS also finalized its updates to the MA Star Rating program to better reflect the socioeconomic and disability status of beneficiaries.

Among changes CMS made from its proposal, the agency finalized a lower amount of encounter data for calculating risk scores. In addition, CMS will phase in proposed cuts to employer group MA plans for retirees. A fact sheet is available on CMS’ website