CMS Releases 2024 Advance Notice with Proposed Payment Updates for the Medicare Advantage and Part D Prescription Drug Programs
Today, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Advance Notice for the Medicare Advantage (MA) and Part D Prescription Drug Programs that would update payment policies for these programs. The Advance Notice builds on a proposed rule that CMS released in December 2022 that would, if finalized, strengthen beneficiary protections for the millions of people who rely on Medicare Advantage and Medicare Part D prescription drug coverage.
In addition to the payment updates, the Advance Notice outlines several updates and improvements made by the Inflation Reduction Act (IRA) to the Part D program that will go into effect or be in effect on January 1, 2024. These include the continuation of reduced cost-sharing for insulin and eliminated cost-sharing for recommended, preventive vaccines, as well as the elimination of cost-sharing for Part D prescription drugs in the catastrophic phase and expansion of eligibility for full cost-sharing and premium subsidies under the Low-Income Subsidy program. Through these changes to the Part D program for 2024, the new drug law provides meaningful financial relief for millions of people with Medicare by improving access to affordable treatments and strengthening the Medicare program both now and in the longrun.
“Medicare Advantage and Part D prescription drug plans are essential parts of CMS’s vision that all parts of Medicare are working to provide more equitable, high quality, and person-centered care that is affordable and sustainable for the people we serve,” said CMS Administrator Chiquita Brooks-LaSure. “The Advance Notice will maintain strong value and choice for people with Medicare, continue our efforts to improve our programs, and fulfill our mandate to implement the Inflation Reduction Act effectively and efficiently.”
The Advance Notice proposes updates to MA payment growth rates and changes to the MA and Part D payment methodologies. These proposals include technical updates to the MA risk adjustment model to keep the model up to date and improve payment accuracy, such as by fully transitioning to the Internal Classification of Diseases (ICD)-10 system, which has been in use since 2015. In addition, CMS is seeking comment on MA quality measurement under Part C Star Ratings as part of CMS’s overarching efforts to align quality measures across federal programs and with private payers, reduce burden, and improve the effectiveness of quality programs.
“The commonsense proposals in the Advance Notice, coupled with the proposals in the MA and Part D rule released in December, ensure these important programs continue to meet the health care needs of all beneficiaries while improving the quality and long-term stability of the Medicare program,” said CMS Deputy Administrator and Director of the Center for Medicare Meena Seshamani, MD, Ph.D.
The Advance Notice is open for public comment, and comments must be submitted by March 3, 2023. The Medicare Advantage and Part D payment policies for 2024 will be finalized in the CY 2024 Rate Announcement, which will be published no later than April 3, 2023.
The 2024 Advance Notice may be viewed by going to: https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Announcements-and-Documents and selecting “2024 Advance Notice.”