CMS unveils 2013 Medicare Advantage payment and policy guidelines

Federal officials said  Friday that the trend toward relatively low premium charges and stable benefits will likely continue.

Reuters: Government Issues Medicare Advantage Guidelines
The Obama administration on Friday issued 2013 payment and policy guidelines for U.S. health insurers that participate in the Medicare Advantage program, saying the proposed changes would bring lower premiums and stable or improved benefits. But the documents did not include an official preliminary estimate for the net average percentage change in reimbursements, leaving insurers and financial markets in the dark about the guidelines' potential impact on the industry (2/17).

CQ HealthBeat: CMS: Trend Toward Low Premiums, Stable Benefits To Continue
Relatively low premium charges and stable benefits have been a hallmark of the private health care plans and prescription drug plans in the Medicare program of late, and that trend will continue, federal officials said Friday. Officials released a "growth percentage" for per capita expenditures in Medicare and said it will be used to set 2013 rates for Medicare Advantage plans, the private managed care health plans in Medicare. The figure -; 2.47 percent -; "will help ensure that beneficiaries maintain a choice of plans without significant increases in premiums or decreases in benefits," said a CMS news release. CMS will publish a rate announcement for 2013 on April 2 (Reichard, 2/17).

Politico Pro: CMS Releases Medicare Advantage Guidance
CMS posted its 2013 payment guidance for Medicare Advantage and Part D plans late Friday, projecting an estimated annual growth rate of about 2.5 percent for the private Medicare plans. The document lays out guidance for insurance plans that want to participate in the programs in the coming year. It's open for public comment, and final rates will be published April 2. CMS will again exercise the authority granted by health reform to deny bids from plan sponsors that propose "too significant" an increase in beneficiary cost-sharing or a decrease in benefits, according to a release announcing the guidance (Norman, 2/17).

Modern Healthcare: CMS Seeks Input On Payment, Policy Updates For Advantage, Prescription-Drug Plans
The CMS announced it is accepting public comments on the agency's proposed payment and policy guidance for Medicare Advantage and prescription drug plans in 2013. According to the Advance Notice and draft Call Letter for 2013, the CMS proposes that it will again use its authority under the Patient Protection and Affordable Care Act to deny bids if the agency decides the bid proposes too high of an increase in cost sharing or a decrease in benefits (Zigmond, 2/19).