Becker's Healthcare March 31, 2023
CMS will move ahead with Medicare Advantage risk adjustment changes payers and some provider groups opposed, but the agency will phase in the model over three years.
The agency published its 2024 rate announcement on March 31. Payers were against the coding adjustments, which industry groups said would amount to a cut in funding for the program.
CMS will shift MA’s diagnosing coding from ICD-9 to ICD-10 and remove certain codes from the Hierarchical Condition Categories model, in addition to other changes to risk adjustment payments.
Some plans argued removing some codes related to vascular conditions, diabetes and depression will hurt plans serving dual-eligible members or those with chronic conditions.
CMS has maintained the risk adjustment...
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