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The proposal includes a 0.09% increase in net average payments for Medicare Advantage plans in 2027, according to a Monday release from the Centers for Medicare and Medicaid Services. The figure is well below Wall Street analysts’ expectations that authorities would propose a 4% to 6% rate hike next year.
CMS typically finalizes Medicare Advantage rates in early April. If the current proposal remains in place, the rate hike would result in payments to Medicare Advantage plans exceeding $700 million in 2027, according to an agency release.
Closely monitored government payment rates determine the monthly premiums and plan benefits provided by insurance companies, and ultimately how much of their profits you can claim. The Wall Street Journal first reported on the government’s interest rate proposal on Monday.
Medicare Advantage is a privately operated health insurance plan contracted by Medicare. According to health policy research firm KFF, more than half of Medicare beneficiaries enroll in these plans, drawn by the low monthly premiums and additional benefits not covered by traditional Medicare.
CMS said it is also considering cutting back on billing practices in money-making industries. Some of the proposals are aimed at improving payment accuracy and ensuring Medicare insurers receive appropriate reimbursement, the Journal reported.
“These proposed payment policies are designed to ensure that Medicare Advantage works better for the people we serve,” CMS Administrator Dr. Mehmet Oz said in the release. “By strengthening payment accuracy and modernizing risk adjustments, CMS will help beneficiaries choose affordable plans and continue reliable benefits, while protecting taxpayers from unnecessary spending that is not intended to address real health needs.”
