CMS Announces 8.5% Increase in Medicare Part D and Medicare Advantage Rates

The Centers for Medicare and Medicaid Services (CMS) and the Biden administration have finalized rate hikes of 8.5% for Medicare Part D and Medicare Advantage plans. This raise is somewhat higher than the 7.98% increase proposed in February, a change spurred by the application of the rebasing/repricing impact that was released after the advance notice. CMS also announced an effective growth rate of 4.88%, which was also higher than the advance notice.

According to Robert King of Fierce Healthcare, “CMS did not change the planned coding pattern adjustment of 5.9% to reflect any differences in diagnosis coding between MA plans and fee-for-service providers, with that being the statutory minimum. The agency acknowledged it had received several comments asking for a higher adjustment than the minimum and that CMS must consider differences in coding patterns across MA plans.”

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(Source: Fierce Healthcare, April 4^th, 2022)