Last week, the Centers for Medicare & Medicaid Services (CMS) published the 2017 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter (2017 Final Notice and Call Letter). In March, Medicare Rights submitted comments on the draft version of the call letter supporting of many of the proposed changes, which seek to improve the accuracy of payment structures and strengthen plan accountability. The 2017 Call Letter finalizes most of the proposals included in the draft letter, with some moderate changes.

This week, Medicare Rights submitted comments requesting that the Centers for Medicare & Medicaid Services (CMS) withdraw a proposal to explore requiring prior authorization for home health care services. These services include home-based skilled nursing and therapy care for people with Medicare who are homebound, meaning they are unable to leave their home without difficulty.

Recently, the Centers for Medicare & Medicaid Services (CMS) Innovation Center proposed a demonstration to test new strategies to pay for medications that are covered under Part B. Most prescription medications are covered under Medicare Part D, but some (mostly those administered by a doctor) are paid for under the outpatient Part B benefit.

Common Part B prescription drugs treat cancer, macular degeneration, anemia, and arthritis. Part B medications tend to be very expensive—in 2013, Medicare and its beneficiaries spent $19 billion on Part B prescriptions.

Last week, Medicare Rights wrote to the Medicare Payment Advisory Commission (MedPAC) responding to three proposals under consideration by MedPAC to alter the Part D prescription drug program. Established in 1997, MedPAC is an independent federal body made up of 17 members with diverse expertise in the financing and delivery of health care services. MedPAC regularly makes recommendations to Congress regarding the administration of the Medicare program.

The budget proposal approved this week by the U.S. House of Representatives Budget Committee is predicted to balance the federal budget in nine years, largely through across-the-board reductions in spending. One exception to these cuts is an increase of $90 billion dollars in defense spending. The proposed changes to the health care system are profound.

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.