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Specifically, the proposed increase in operating and capital IPPS payment rates will increase hospital payments in FY 2025 by approximately $2.9 billion. In addition, CMS projects Medicare uncompensated care payments to disproportionate share hospitals (DSH) will increase in FY 2025 by approximately $560 million.
The U.S. Centers for Medicare and Medicaid Services (CMS) published a final rule on April 4, 2024 that overhauls the regulations governing insurance agent and broker compensation rates and agreements for Medicare Advantage Plans (MAPs) and Medicare Part D Plans (PDPs).
The Centers for Medicare Medicaid Services April 4 finalized changes to the Medicare Advantage and prescription drug programs for contract year 2025 intended to improve access to behavioral health care; cap and standardize MA plan compensation to brokers, including prohibiting volume-based bonuses for enrollment into
Enhancements to Medicare Advantage and Medicare Part D Limiting the Distribution of Personal Beneficiary Data by Third-Party Marketing Organizations. Improving Access to Behavioral Health Care Providers. Mid-Year Enrollee Notification of Available Supplemental Benefits.
Most Medicare Advantage Plans include Medicare drug coverage (Part D). In certain types of plans that dont include Medicare drug coverage (like Medical Savings Account Plans and some Private Fee-for-Service Plans), you can join a separate Medicare drug plan.
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The 3.7% includes a blended MA risk score trend (risk adjusted payments) of 3.86%. However, risk score trends vary by plan. In addition, the final rate includes a decrease in benchmark rates for 2025 of 0.16%. As expected, CMS is continuing its three-year phase in of the risk adjustment model changes initiated in 2024.
Last week, the Centers for Medicare Medicaid Services (CMS) announced the 2025 payment rates for Medicare Advantage (MA) and Part D plans. The final policies largely align with those proposed in the Advance Notice and are expected to increase Medicare payments to MA plans by 3.7%over $16 billionnext year.
Medicare Advantage plans are required to follow all Medicare laws and coverage policies, including LCDs (Local Coverage Decisions - coverage policies set by Medicare Fee-for-Service Contractors in your geographic area), when determining coverage for a particular service.

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