CMS Issues 2016 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter

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On April 6, 2015, CMS released final updates to the Medicare Advantage and Part D programs through its 2016 Rate Announcement and Call Letter.  CMS estimates an expected average change in revenue of 1.25 percent with respect to these programs for 2016.   When it issued the Advance Notice and Draft Call Letter in February 2015, CMS had initially estimated a 0.95 percent reduction in revenue for 2016.  After factoring in the statutory minimum coding pattern adjustment of 2 percent, CMS’s final estimate of the expected average change in revenue is 3.25 percent.

For additional information regarding the Advance Call Letter, see our February 23, 2015 article in Health Headlines, available here.  CMS’s Final 2016 Rate Announcement and Call letter is available by clicking here, and a copy of CMS’s press release is available by clicking here.

Reporter, Ramsey Prather, Atlanta, +1 404 572 4624, rprather@kslaw.com.

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