MA and Part D Proposed Rule

December 6, 2017

On November 16th, the Centers for Medicare and Medicaid Services (CMS) issued a rule that proposes significant regulatory changes for Medicare Advantage (MA) and Prescription Drug Benefit (Part D) plans, beginning in contract year 2019. For MA and Part D plans, the rule would generally ease reporting requirements, update the Medicare Star Rating methodology, remove the meaningful difference requirement for new plan offerings, and redefine marketing materials. The rule also includes many provisions that are specific to MA or Part D plans, such as benefit tailoring based on health condition and drug tiering rules. CMS estimates that the proposed rule would result in approximately $195 million in net savings for Medicare between 2019 and 2023.

CMS will accept comments on the proposed rule until January 16, 2018.

A summary of major provisions of the proposed rule is attached. The rule is available here.