The Centers for Medicare & Medicaid Services has issued Medicare Advantage and Part D updates that include an average payment increase of 1.84% and policy changes that include new supplemental benefits for services that improve health and quality of life.
According to a call letter for plan sponsors published Thursday in anticipation of 2019 bidding, coverage would expand for non-skilled in-home supports like portable wheelchair ramps and other assistive devices and modifications when needed.
"CMS has previously not allowed an item or service to be eligible as a supplemental benefit if the primary purpose included daily maintenance,” the letter explained. “Under the new policy … CMS would allow supplemental benefits if they compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency room utilization."
CMS Administrator Seema Verma said the expansion is an example of addressing beneficiaries' needs, while creating more treatment flexibility and ensuring consumers have more choices.
In 2018, Medicare Advantage and Part D premiums decreased and the number of Medicare Advantage plans available increased from about 2,700 to more than 3,100. CMS said MA enrollment “is at an all-time high” with about one-third of all Medicare beneficiaries are enrolled in a plan.
In fiscal 2019, payments to plans will rise an average of 1.84%, increasing to 3.1% when factoring in plan coding of member diagnoses.
In the proposal, CMS also discusses its move toward evaluating acute readmissions of Medicare Advantage beneficiaries, 11% of whom require skilled nursing care after hospitalization.
“A readmission event during or after a SNF stay may be the result of inadequate provider communication during care transitions and poor discharge planning,” CMS said.
CMS will accept feedback on the feasibility and burden of the proposed changes through March 5
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