On Jan. 15, CMS issued 2022 Medicare Advantage and Part D rates three months early in a move it says will give plans more time to calculate bids for the next coverage year.
Five things to know:
1. The agency expects the rates will increase per-capita plan payments by 4.08 percent on average, according to a fact sheet.
2. Under the rate announcement, CMS said it will complete phasing in a model that changes how the agency calculates risk scores for Medicare plans. The new risk model includes variables that consider the number of conditions a member has and additional conditions for mental health, substance use disorder and chronic kidney disease.
3. CMS said the Medicare Part C risk score used for payment in the 2022 coverage year will rely entirely on Medicare Advantage encounter data and fee-for-service claims as the sources of diagnoses.
4. For 2022, CMS is finalizing a proposal to apply a coding pattern adjustment of 5.90 percent, the minimum adjustment for coding intensity that's required. The rate announcement also includes the date that plans must submit requests for changes to the appeals and complaints measures data for 2022 Star Ratings. The date is June 30.
5. CMS released the rates early so Medicare health and Part D prescription drug plans could review them before they finalize their bids for 2022. Final bids are due June 7.
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