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Date ArticleType
1/3/2018 Payment/Reimbursement
CMS Issues Advance Notice for MA CMS-HCC Risk Adjustment Model

Late last week, the Centers for Medicare & Medicaid Services (CMS) issued Part I of the Advance Notice of Methodological Changes for Calendar Year (CY) 2019 for Medicare Advantage (MA) plans.  As a reminder, the annual Advance Notice includes updated payment rate information and guidance to MA plan sponsors as they prepare bids for the upcoming plan year.  In a departure from previous years, CMS is publishing the 2019 Advance Notice in two parts due to requirements in the 21st Century Cures Act which mandate a 60-day comment period for certain changes to the CMS hierarchical condition category (HCC) risk adjustment model. Part II, which will include proposed changes to other requirements and payment methodologies that only require a 30-day comment period, is scheduled to be released on or before January 31, 2018. Please click here for more detail.