Becker's Healthcare December 15, 2023
Rylee Wilson

CMS will implement new risk adjustment payment rates, prior authorization requirements and network standards for Medicare Advantage plans in 2024.

Here are five changes coming to the program in 2024:

  1. CMS will begin phasing-in risk adjustment payment changes in 2024. The agency will phase in the rate changes, which payers have said amount to funding cuts, over three years. CMS Medicare Advantage plans will see an average payment increase of 3.32 percent between 2023 and 2024.
  2. MA plans will have new prior authorization requirements to comply with in 2024. In its 2024 final rule, CMS said coordinated care plan prior authorization policies may only be used to confirm the presence of diagnoses or other medical criteria...

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Topics: CMS, Govt Agencies, Insurance, Medicare Advantage
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