Better Medicare Alliance Issues Comment Letters in Response to CMS’ Advance Notice, Proposed Rule
Coalition expresses support for CMS policies that will ensure stability for more than 28 million Medicare Advantage beneficiaries; applauds CMS’ health equity goals and proposals related to dual-eligible beneficiaries while encouraging caution on pharmacy price concession and maximum out-of-pocket changes
Washington, D.C. – Better Medicare Alliance, the nation’s leading research and advocacy organization supporting Medicare Advantage, issued a pair of comment letters in response to the Centers for Medicare & Medicaid Services’ (CMS) 2023 Medicare Advantage Advance Notice and proposed rule.
“CMS delivered a thoughtful Advance Notice and proposed rule that protects seniors and reflects many of our shared goals – accelerating the drive to health equity, building on Medicare Advantage’s capacity to address social determinants of health, continuing to assess changes that will help beneficiaries on their journey with end-stage renal disease, and addressing the confusion and fragmentation that can happen between Medicare and Medicaid, to name a few,” said Mary Beth Donahue, President and CEO of the Better Medicare Alliance.
“As we heartily support CMS in many of these efforts, our comments also encourage the agency to consider the full impact of maximum out-of-pocket changes that could disproportionately impact plans that serve higher proportions of dual-eligible beneficiaries and curtail supplemental benefit offerings,” Donahue continued. “Better Medicare Alliance additionally encourages CMS to consider a delay of its proposed pharmacy price concession changes, which could limit access to zero-dollar premium plans and raise costs for the 9 in 10 Medicare Advantage beneficiaries enrolled in an integrated MA-PD plan. We look forward to a final rule and Rate Announcement that preserves and strengthens Medicare Advantage for the more than 28 million satisfied, diverse beneficiaries counting on its coverage and care.”
In its comment letters on the Advance Notice and proposed rule, sent last Friday and today, respectively, Better Medicare Alliance addresses key provisions of CMS’ guidance, including:
- Addressing social determinants of health and advancing health equity: In its comment letter on the Advance Notice, Better Medicare Alliance writes that it appreciates a “number of the thoughtful policy options to better address social risk factors and provide incentives for Medicare Advantage plans to drive continued improvements in reducing disparities and closing gaps in care, including consideration of new quality measures and establishing a health equity index.” The coalition goes on to add that it “looks forward to partnering with CMS on efforts to support accurate and comprehensive social determinants of health data collection to achieve these proposals and priorities.”
- Medicare Advantage end-stage renal disease (ESRD) payment: In its comment letter on the Advance Notice, Better Medicare Alliance writes that it “appreciates CMS’ continued analysis of the methodology for setting ESRD payment rates in Medicare Advantage” and “urge[s] CMS to change Medicare Advantage ESRD rates to a sub-state level to ensure payment and policies enable health plans and providers to offer high-quality care and treatment for beneficiaries with ESRD, without decreasing supplemental benefits or increasing premiums or the cost burden for all Medicare Advantage beneficiaries.”
- Web-based Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey: In its comment letter on the Advance Notice, Better Medicare Alliance writes that it “supports a pilot for a web-based CAHPS survey, with the intent to move towards a permanent online format.”
- Maximum Out-of-Pocket (MOOP) limit: In its comment letter on the proposed rule, Better Medicare Alliance responds to CMS’ proposal to change the methodology for calculating spending toward the MOOP and encourages CMS to “carefully consider” the impact on supplemental benefit offerings and dually-eligible beneficiaries, writing: “there is concern that this complex population may see a reduction in enhanced benefits or supplemental benefits as a result of this proposed policy change, yet this population is one that needs the robust benefits and innovative supplemental benefits addressing social determinants of health the most.”
- Pharmacy price concessions in the negotiated price: In its comment letter on the proposed rule, Better Medicare Alliance writes that “the consequences of this proposed policy change are far reaching and can have a significant impact on $0 premium MA-PD plans and the millions of Medicare Advantage beneficiaries that choose to enroll in one of those plans each year.” The coalition goes on to request a delay of at least one year so health plans have time to adequately implement the policy and limit the impact on beneficiaries.
Better Medicare Alliance’s comment letters come on the heels of bipartisan Congressional letters to CMS, in which a record-setting combined 409 members of the U.S. House and Senate declared support for Medicare Advantage and urged CMS to provide stability for beneficiaries with its regulatory changes for 2023.
Read Better Medicare Alliance’s comment letter on the 2023 Medicare Advantage Advance Notice here.
Read Better Medicare Alliance’s comment letter on the 2023 Medicare Advantage proposed rule here.