Last week, the Medicare Rights Center submitted comments in response to the Centers for Medicare & Medicaid Services (CMS) 2017 Advance Rate Notice and draft Call Letter (2017 Call Letter) for the Medicare Advantage (MA) and Part D programs. The 2017 Call Letter proposes a variety of updates, including changes to payment methodologies designed to improve the accuracy of payments to plans serving beneficiaries dually eligible for Medicare and Medicaid, and modifications to payment structures for employer-sponsored MA plans. CMS also seeks comments on policies to improve the accuracy of MA plan provider network directories, Part D plan audits related to auto-forwarded appeals cases, and opportunities to improve beneficiary access to medications for people turned away at the pharmacy counter.
On the one hand, Medicare Rights’ comments are supportive of many of the proposed changes, which seek to improve the accuracy of payment structures and strengthen plan accountability. The comments express concern, on the other hand, about the lack of progress made on promised improvements to Part D coverage and appeals processes. Medicare Rights continues to hear from people with Medicare who face persistent confusion and challenges when denied access to a medication at the point of sale and encourages CMS to strengthen the Part D appeals process.
Read the comments: