The Centers for Medicare and Medicaid Services (CMS) have unveiled their proposed 2025 payment updates for private insurers in Medicare Advantage and Part D Programs. CMS plans to raise payments to these programs by an average of 3.7% (totaling $16 billion), attributing the increase to anticipated growth in patient risk scores using a risk adjustment methodology.
In addition to the payment updates, CMS has outlined significant improvements to the Medicare Part D drug benefit structure to reduce drug costs for millions of Medicare beneficiaries. Health and Human Services Secretary Xavier Becerra stressed the importance of affordable prescription drugs, highlighting the Biden-Harris Administration's dedication to ensuring optimal care for the millions enrolled in managed care plans like Medicare Advantage, all while maintaining efficient use of taxpayer dollars.
Applauding the move, the California Medical Association (CMA) supports the reduced prescription drug costs for Medicare Part D patients. The CMA is currently scrutinizing the proposal to assess its potential impact on physicians and patients. Interested parties can submit comments until March 1, 2024, with CMS expected to finalize the rule by April 1, 2024.