Arnold Ventures Statement on CMS Final Rule for Medicare Advantage and Part D Payment Updates

Mark E. Miller, executive vice president of health care at Arnold Ventures, issued this statement after the Centers for Medicare & Medicaid Services (CMS) released finalized payment updates for Medicare Advantage (MA) and Part D:

“We commend CMS for finalizing its proposal to amend Medicare Advantage risk adjustment to no longer count diagnoses that appear in medical charts but are not connected to actual care. This is an important step toward improving payment accuracy.

“We encourage CMS to take steps to address other sources of upcoding and other drivers of overpayments to Medicare Advantage insurers. Doing so will improve program integrity and ensure increased competition in MA based on value for beneficiaries and taxpayers.

We also urge Congress to consider MA reforms, such as those proposed in the No UPCODE Act.”