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CMS Proposes Updates for Medicare Advantage Plans

The Centers for Medicare & Medicaid Services (CMS) released Feb. 21 its calendar year (CY) 2015 draft call letter and advance notice, which proposes payment and policy updates for Medicare Advantage plans. In particular, CMS proposes to adjust fee-for-service (FFS) claims from 2008-2012 to account for fiscal year (FY) 2014 Medicare disproportionate share hospital (DSH) payments. The Affordable Care Act (ACA) mandates that eligible hospitals continue to receive 25 percent of their estimated Medicare DSH payments and separate uncompensated care (UC) payments based on the hospital’s relative UC costs. CMS stated that this adjustment will improve the accuracy of the FFS rates used to determine Medicare Advantage capitated payments for CY2015.

Comments on the proposed call letter are due March 7. The final 2015 rate announcement and call letter, which includes the final Medicare Advantage plan rates, will be published April 7.

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