AMCP Summary - Medicare and Medicaid Programs; Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit, Program of All-Inclusive Care for the Elderly (PACE) Medicaid Fee-for-Service, and Medicaid Managed

Topic(s):

Legislation & Regulation , Medicare Part B , Medicare Part D , Medication Therapy Management (MTM)

On Nov 1, The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that updates Medicare Advantage (MA or Part C) and the Medicare Prescription Drug Benefit Program (Part D). The purpose of the proposed rule is to implement several provisions in the Bipartisan Budget Act of 2018, improve program quality and accessibility, and propose policies that strengthen program integrity. Proposed provisions are intended to reduce provider burden and promote flexibility and innovation that will provide MA and Part D sponsors with tools to improve quality of care and increase choice for MA and Part D enrollees. CMS estimates that, if finalized, the proposed changes would result in $4.5 billion dollars in savings to the Medicare Trust Funds over ten years. CMS plans to release another proposed rule to address the Administration’s agenda of reducing drug costs. The second rule is currently under review at the Office of Management and Budget (OMB).