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Medicare Advantage association, CMS clash over impact of proposed payment changes

Medicare Advantage association, CMS clash over impact of proposed payment changes

Proposed payment changes for Medicare Advantage plans could reduce benefits for Wisconsinites by more than $400 next year, according to an independent analysis funded by a Medicare Advantage advocacy group and disputed by the Centers for Medicare and Medicare Services.

In February, CMS released an annual notice describing proposed payment and coverage policies in Medicare Advantage for the 2024 plan year and predicted the changes would result in a 1 percent increase in payments. Public comment on the notice closes Monday, with a final notice to be issued next month.

The Better Medicare Alliance, which advocates for Medicare Advantage, released a study predicting a 2.3 percent decline. In Wisconsin, that would amount to a $408.54 annual impact for the more than 500,000 people in Medicare Advantage plans, according to the analysis.

Better Medicare Alliance CEO Mary Beth Donahue said they want to see CMS reconsider and not move forward with the changes.

“There are massive cuts,” Donahue said. “If they do go through, seniors will see an impact in higher premiums and also changes to their plan benefit.”

A CMS spokesperson said any claim they’re cutting Medicare is “categorically false.” The federal regulatory agency is reviewing the study and believes that it has “serious methodological issues.”

“We do not believe that it accurately portrays the impact of the ($4 billion) payment increase that CMS is proposing,” the spokesperson said.

While there may be variation among Medicare Advantage plans, the proposal will ensure “stability” in the program and a “broad array of choices,” they said.

In a column last month, Jeannie Fuglesten Biniek, an associate director for the program on Medicare policy at the Kaiser Family Foundation, wrote that there is “no clear evidence to suggest” that the proposed payment changes would lead to premium increases or benefit cuts for beneficiaries. Plans use federal payments in excess of cost to provide extra benefits or lower premiums, she said.

“In theory, lower payments from the federal government could reduce the surplus available for extra benefits,” she wrote. “However, plans also compete aggressively for enrollees with zero premiums and those extra benefits.”

This article first appeared in the Wisconsin Health News daily email newsletter. Sign up for your free trial here.


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