Lexology February 15, 2024
On January 31, 2024, the US Centers for Medicare & Medicaid Services (CMS) released the Advance Notice of Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and D Payment Policies. CMS also released a press release and fact sheet. The advance notice is released on an annual basis and includes proposed updates to the capitation and risk adjustment methodologies used to calculate payments to MA plans, as well as other payment policies that impact Part D. Comments are due March 1, 2024. The final CY 2025 rate announcement will be published no later than April 1, 2024.
Among other provisions, the advance notice includes the following proposals:
Payment Changes/Growth Rates: The effective...
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