CMS Seeking Public Input on Updates to Medicare Advantage and Part D Prescription Drug Coverage – Comment by March 1

The Centers for Medicare & Medicaid Services (CMS) is required to update Medicare Advantage (MA) payment rates and other policies for calendar year 2025.  The full Advance Notice may be viewed on the CMS website by selecting “2025 Advance Notice.”  For Medicare Advantage, CMS proposes to continue phasing in previously finalized adjustments to plan pay rates as well as make new adjustments for MA plans in Puerto Rico.  They also request input on future quality measures.  For the Part D Prescription Drug program, CMS invites comment on draft guidance implementing parts of the Inflation Reduction Act of 2022 (IRA) that take effect in 2025.  Specifically, the IRA creates a newly defined standard Part D benefit design; lowers the annual out-of-pocket threshold; establishes the Manufacturer Discount Program, under which manufacturers provide discounts on applicable drugs in the initial coverage phase and catastrophic phase of the defined standard drug benefit; and changes the liability of enrollees, sponsors, manufacturers, and CMS.  In recent years, non-metro areas have seen slightly higher growth in the number of MA plans and enrollment than metropolitan counties.

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