CMS Proposal Could Disrupt Care & Increase Premiums for Medicare Advantage Patients

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Senate Finance Committee Republicans, led by Ranking Member Mike Crapo (R-Idaho), are urging government health officials to take steps to prevent adverse outcomes for patients who rely on Medicare Advantage (MA) following a February 2023 proposal from Centers for Medicare and Medicaid Services (CMS).  The proposal includes changes to the diagnostic system for some chronic conditions, including diabetes and congestive heart failure, that could cause disruptions in care and sudden premium increases.

In a letter to U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure, the senators highlight concerns of various patient groups and providers that found the Advance Notice would have a major impact on premiums and seniors’ benefits.

“As the Centers for Medicare and Medicaid Services (CMS) considers options for moving forward on proposed risk adjustment modifications and other policy shifts for MA, we encourage the agency to take steps to maintain program stability, protect beneficiaries from potential disruptions, mitigate unfavorable impacts for seniors, and provide policymakers with transparency and clarity regarding CMS’s decision-making processes,” the Senators write.

The proposal wants to change how risk is measured. The Senators believe this might be bad for seniors. Moreover, it is a complicated policy, so it might cause confusion if it happens too quickly. the reforms could spur confusion and uncertainty among health care providers and plans.

Read the full letter here.

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