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May 29, 2020

CMS New Final Rule Will Impact Medicare Advantage and Part D

On May 22, CMS issued a final rule that is intended to enhance Medicare Advantage and Part D in numerous ways, including, among other changes, allowing individuals with End-Stage Renal Disease to enroll in Medicare Advantage plans beginning January 1, 2021, and by updating the Part C and D Star Ratings. The final rule also made changes to the Medicare Advantage medical loss ratio calculations, codified and developed new network adequate methodology to support plans in rural areas, and codified the additional Special Election Periods it has previously issued. The rule also finalized CMS’s plan to limit Dual Eligible Special Needs Plan “look-alike” plans in order to allow CMS to effectively implement the requirements for D-SNPs set out in the Bipartisan Budget Act of 2018.