CMS, Insurers Clash Over Whether Medicare Advantage Is Going to Be Cut in Proposed Rule

Posted February 15, 2023

Insurers and the Biden administration are at odds over whether Medicare Advantage (MA) plans will experience a pay cut next year, which would be come from the increase of scrutiny for the program.

Insurer groups and a number of politicians state that  the latest 2024 payment rule really means a 2.27% cut to MA plans once risk adjustment changes and other factors are enacted. CMS disagrees, saying that it is not the case.

The debate comes amid increasing scrutiny of MA and after CMS has proposed an overhaul to plan audits to curb overpayments.

“We think it is important not to cherry-pick the numbers,” said CMS Administrator Chiquita Brooks-LaSure during a call with reporters last week. “When we look at all the elements, we do see a net positive so an increase of little over 1%.”

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