Lexology April 2, 2024
On April 1, 2024, the US Centers for Medicare & Medicaid Services (CMS) released the Announcement of Calendar Year (CY) 2025 Medicare Advantage (MA) Capitation Rates and Part C and D Payment Policies (Rate Announcement). CMS also issued a press release, fact sheet and Part D redesign program instructions. The Rate Announcement is released on an annual basis and includes updates to the capitation and risk adjustment methodologies used to calculate MA plan payments, as well as other payment policies that impact Part D. The Rate Announcement largely finalizes the policies CMS previously proposed in its Advance Notice released on January 31, 2024.
Among other provisions, the Rate Announcement includes the following updates:
MA Payment Changes/Growth Rates: The effective growth...
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