CMS can terminate private Medicare plans with poor Star Ratings again

CMS informed Medicare Advantage and Part D drug plans that it will begin to terminate their contracts if they consistently achieve poor Star Ratings, according to a Feb. 6 memorandum.

Five things to know:

1. The memorandum said a previous moratorium on CMS' ability to terminate Medicare Advantage contracts based on low Star Ratings expired Dec. 31.

2. As a result, the agency will resume the authority to terminate a contract that has failed to receive at least three stars for three consecutive contract years.

3. CMS will use the Star Ratings released after Dec. 31 as the first set it could count toward a plan's possible termination.

4. Star Ratings for Medicare Advantage and Part D plans are released in the fall. The 2020 Star Ratings — released in the fall of 2019 — will be the first round of ratings counted toward possible termination.

5. Contracts, therefore, can't be terminated until Star Ratings for 2022 are released, according to CMS.

For more information, click here.

More articles on payers:
BCBS Association CEO to testify in court over Anthem-Cigna breakup
The state of Medicaid expansion
After reviewing 173 comments, DOJ stands by CVS-Aetna settlement

© Copyright ASC COMMUNICATIONS 2019. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Top 40 Articles from the Past 6 Months