Medicare Advantage Plan Ratings May Be Adjusted After Fairness Complaints
Elsewhere, a proposal to stave off a $54-per-month increase in Medicare premiums for some seniors could lead to a budget battle on Capitol Hill.
Medicare Advantage Star Ratings May Change To Address Fairness Complaints
Top CMS officials signaled this week that the agency will consider altering Medicare Advantage quality ratings to adjust for socio-economic characteristics of a plan's enrollees. Health plans that primarily serve low-income members and people who are dually eligible for Medicare and Medicaid complain they unfairly get lower star ratings that make them ineligible for bonuses and put them in danger of losing their Medicare contracts. The CMS has the statutory authority to boot a plan if it has fewer than three stars for three straight years. (Dickson, 10/20)
Medicare Premium Hike Could Add Spice To Year-End Budget Deal
Congressional efforts to block a looming premium spike for millions of Medicare beneficiaries could add upwards of $10 billion to the cost of a budget deal but also provide powerful incentives for lawmakers to throw their weight behind an agreement. An estimated 16.5 million seniors, or 30 percent of enrollees in Medicare Part B, are expected to see their monthly premiums for doctors’ visits and outpatient services rise by at least $54 in 2016. The remainder are protected by a “hold harmless” provision preventing Part B premiums from rising more than their Social Security paychecks. Podcast:Health law sign-ups and Medicare premiums. (Attias, 10/20)