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CMS Finalizes Medicare Advantage and Part D Changes for 2019

This week, the Centers for Medicare & Medicaid Services (CMS) released the final Medicare Advantage and Part D 2019 Rate Announcement and Call Letter. This is the finalized annual update to Medicare Advantage and Part D programs, which includes payment updates and policy changes for calendar year (CY) 2019. CMS also released a preview and fact sheet of the Final Rule Implementing Policy and Technical Changes to Part C and Part D for CY 2019, which will be formally published at a later date.

Notable changes for the 2019 plan year include:

  • Eliminating the Star Rating Measure that separately captures the results of audits and enforcement actions.
  • Expanding the ability for plans to offer supplemental benefits that are health related but are not covered by Traditional Medicare, including benefits that address the social determinants of health, like nutritional support.
  • Finalizing a new method for calculating payments to Medicare Advantage plans that employers can offer to Medicare enrollees.
  • Expanding the list of conditions included in the CMS-HCC Risk Adjustment Model.

Together with the changes in the proposed rule, this Rate Announcement and Call Letter provides for increased plan flexibility and reduced oversight. As Medicare Rights outlined in our comments to both draft documents, this flexibility will require increased understanding, vigilance, and research by beneficiaries as they choose and utilize coverage through Medicare Advantage Plans.

View the CMS fact sheet.

View the 2019 Rate Announcement and Call Letter.

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