Support CMS 2024 Medicare Advantage Payment Rules

February 21, 2023

Summary: Today’s post is a request to comment favorably (by March 3rd) on proposed payment adjustments for Medicare Advantage for 2024.

CMS issued a draft of a plan for 2024 payments to Medicare Advantage plans. Overall it’s a 1% increase, after taking into account various technical factors. While it doesn’t address all serious Medicare Advantage over-charging problems, it does address some. It’s a decent start. A big change from last year when the MA plans got an 8.5% increase. Insurers are asking for a larger increase. We should support CMS on this one.

Write to CMS to endorse this proposed approach. By March 3rd. Below are some bullets to consider for your comment to CMS. Please adapt them into your own words … thanks!

By the way, if you’re an economist or similarly focused academic, contact me to review and I hope sign a technical version of the CMS comment.

– JGK

Fact sheet on this announcement is here.

Comment submission instructions:

Comments are due by Friday, March 3, 2023.

Go to www.regulations.gov, enter the docket number “CMS-2023-0010” in the “search” field, and click on “Comment”. You can paste or type your comment, or upload a file.

• Writing to support — CMS 2024 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part C and Part D Payment Policies.
  
• The changes proposed by CMS are critically important. They begin to correct overpayment of Medicare Advantage plans by tens of billions of dollars per year due to exaggerated diagnostic coding. Further billions in excess payments are created by recruiting healthier patients and shedding sicker ones. These massive excess payments are depleting the Medicare Trust fund in order to feed huge profits for health insurers.
  
• Although the proposed payment adjustments do not address all problematic diagnostic coding practices, they correct important flaws in coding rules and risk adjustment that contribute to the magnitude of overcharging.
  
• As a [current or prospective] Medicare beneficiary, I count on CMS to provide responsible stewardship of the program. The proposed adjustments are part of this stewardship.
  
• As a taxpayer, I expect the same.
  
• The proposed net 1% increase in revenue for Medicare Advantage plans will permit continuation of current benefits and ample profits for the plans. Past increases of 8% were a gift to the insurers, at the expense of beneficiaries and taxpayers.
  
• Please issue the final procedures as drafted.

Respectfully submitted,