CMS finalizes Medicare Advantage, Part D payment policies: 4 things to know

CMS issued a final rule April 1 to update 2020 payment policies for Medicare Advantage and Part D prescription drug plans.

The Centers for Medicare & Medicaid Services (CMS) finalized updates that will take significant steps in continuing the Trump administration’s efforts to increase competition among Medicare Advantage and Part D plans so patients get higher quality care at lower costs. These changes will increase plan choices and benefits, and include important actions to address the opioid crisis.

“Today’s changes give plans the ability to be innovative and offering benefits and services that address social determinants of health for people with chronic disease,” said CMS Administrator Seema Verma. “With Medicare Advantage enrollment at an all-time high, plans need greater flexibility in offering benefits that they focus on preventing disease and keeping people healthy.” 

Four things to know:

1. Under the rule, Medicare Advantage health plans will see a 2.53 percent pay raise in 2020.

2. In addition, chronically ill patients with Medicare Advantage can receive coverage for products and services aimed at addressing social determinants of health.

3. This includes meal delivery, transportation for nonmedical needs like grocery shopping and home environment services.  

4. For example, CMS said Medicare Advantage patients with asthma could receive coverage for air cleaners and carpet shampooing to address irritants that could cause asthma attacks. A patient with diabetes could receive coverage for transportation to a physician’s appointment or other services like a nutritionist. 

For the full fact sheet, click here.