CMS releases 2024 advance notice with proposed payment updates for the Medicare Advantage and Part D Prescription Drug Programs
The Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Advance Notice for the Medicare Advantage (MA) and Part D Prescription Drug Programs that would update payment policies for these programs.
In addition to the payment updates, the Advance Notice outlines several updates and improvements made by the Inflation Reduction Act (IRA) to the Part D program that will go into effect or be in effect on January 1, 2024. These include the continuation of reduced cost-sharing for insulin and eliminated cost-sharing for recommended, preventive vaccines, as well as the elimination of cost-sharing for Part D prescription drugs in the catastrophic phase and expansion of eligibility for full cost-sharing and premium subsidies under the Low-Income Subsidy program.
The Advance Notice proposes updates to MA payment growth rates and changes to the MA and Part D payment methodologies. These proposals include technical updates to the MA risk adjustment model to keep the model up to date and improve payment accuracy, such as by fully transitioning to the Internal Classification of Diseases (ICD)-10 system, which has been in use since 2015.
The Advance Notice is open for public comment, and comments must be submitted by March 3, 2023. The Medicare Advantage and Part D payment policies for 2024 will be finalized in the CY 2024 Rate Announcement, which will be published no later than April 3, 2023.
The 2024 Advance Notice may be viewed by going to: https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Announcements-and-Documents and selecting “2024 Advance Notice.”
A fact sheet discussing the provisions of the Advance Notice can be viewed here: https://www.cms.gov/newsroom/fact-sheets/2024-medicare-advantage-and-part-d-advance-notice-fact-sheet
