CMS Will Raise Medicare Advantage Plan Payments By 4.08% In 2022

January 19, 2021

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Source: Fyne Fettle, by James Schneider

CMS will raise Medicare Advantage plan payments by 4.08%, the agency announced Friday.

It also signed off on its controversial proposal to complete a multiyear phase-in of a new payment methodology. The new process will adjust plan payments using diagnoses solely from encounter data—information created by healthcare providers about patients’ medical conditions and treatment. The health insurance industry has long railed against the use of encounter data to adjust their payments. They argue that the data is incomplete and often inaccurate and that using it would lead to lower payments to Advantage plans.

“This announcement is being made nearly three months earlier than usual to provide MA organizations and Part D sponsors more time to take this information into consideration as they prepare their bids for 2022,” CMS said in a fact sheet.

CMS also approved a 5.90% coding pattern adjustment for Advantage plans, which is the lowest adjustment allowed under the law. It also cemented previously approved changes to Medicare Part C and D Star Ratings.

 

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