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June 13, 2024

CMS To Recalculate 2024 Medicare Advantage Star Ratings

After losing two lawsuits on their methodology, the Centers for Medicare and Medicaid Services announced it has recalculated 2024 Star measures for Medicare Advantage (MA) plans.  It will give plans that saw increases a short window to revise 2025 plan bids and benefits that have already been submitted.

Additional article here: https://insidehealthpolicy.com/daily-news/scan-cms-recalculate-ma-star-ratings-rebidding-process-come

(Some articles may require a subscription.)

#medicareadvantage #stars #cms

https://www.beckerspayer.com/payer/cms-to-recalculate-medicare-advantage-star-ratings-report.html

Major MedPAC Recommendations In Annual Report

MedPAC, the congressional policy arm for Medicare, issued its annual report today. It analyzes and makes recommendations for reforming Medicare physician pay, prior authorization in Medicare Advantage (MA), and MA encounter data. I will do an in-depth blog in the near future on the MA recommendations.

(Article may require a subscription.)

#medpac #medicare #providers #medicareadvantage #healthplans

https://insidehealthpolicy.com/daily-news/medpac-june-report-examines-physician-fee-pay-prior-auth-irf

Progressive Warns Of Medicare Drug Negotiation Repeal

The Center for American Progress (CAP), a progressive policy group is sounding the alarm over a conservative policy blueprint on healthcare that calls for repealing the Medicare price negotiations in the Inflation Reduction Act (IRA). It says at least 18.5 million beneficiaries could lose new cost-savings on their medications.

(Article may require a subscription.)

#ira #drugpricing

https://insidehealthpolicy.com/inside-drug-pricing-daily-news/progressive-group-drug-price-control-advocates-prep-prevent-ira

Medicaid Redetermination Process Could Go Into 2025

A revised timeline from the Centers for Medicare and Medicaid Services (CMS) says nine states and the District of Columbia will go past the June 2024 deadline to complete their post-pandemic Medicaid redeterminations, with some going into 2025. The Kaiser Family Foundation says 22.8 million people have lost coverage during the process.  Overall Medicaid rolls are down almost 11 million.

(Article may require a subscription.)

#medicaid #redeteterminations #coverage

https://insidehealthpolicy.com/daily-news/cms-releases-updated-state-unwinding-timelines-two-stretch-2025

Business Groups Worried About A Scaleback Of Healthcare Deduction

Business groups have written Congress asking that the tax deductibility of healthcare costs not be messed with. Many businesses are worried that it could be targeted during major talks on deficit reduction or scaling back the size of government.  The provision is key to coverage as well as the competitiveness of business.  But I am not unsympathetic to some reform that would not subsidize overly rich benefits that lead to greater costs in the healthcare system.  The Cadillac tax, now repealed, was not a bad idea.  Some sort of cap on the subsidy sensitive to regional price differences should be considered. The subsidy costs $348 billion a year, ironically much greater than Obamacare premium subsidies.

(Article may require a subscription.)

#healthcare #coverage

https://insidehealthpolicy.com/daily-news/employer-lobbies-urge-congress-protect-tax-free-health-benefits

Biden Ad On Pre-Existing Condition Protections Mostly True

A Biden campaign ad saying former President Trump could repeal the Affordable Care Act and cause over 100 million Americans to lose protections for pre-existing  conditions has been rated as mostly true.

#election2024 #healthcare #biden #trump

https://kffhealthnews.org/news/article/fact-check-biden-campaign-ad-repealing-obamacare-preexisting-conditions/

— Marc S. Ryan

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