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Impact of COVID-19 Federal Policy on Medicare Advantage

This week, our In Focus section examines the operational impacts of federal Medicare Advantage policy changes in response to the COVID-19 pandemic. On January 31, 2020, the Secretary of Health and Human Services declared a public health emergency. This was followed by a national emergency declared by President Trump on March 13, 2020. These declarations provide the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) authority to waive certain Medicare and Medicaid regulatory requirements to help health plans, providers, and other stakeholders respond to immediate needs of their members and communities. These waiver flexibilities, when combined with other legislative and regulatory changes issued by Congress and CMS have resulted in over 200 policy changes to Medicare alone. Many of these affect Medicare Advantage sponsors and have direct implications to current and future operations of plan responsibilities. We examine eight categories of requirements and flexibilities that have significant business relevance and exposure for Medicare Advantage plan sponsors:

  • Cost sharing
  • Telehealth
  • Star Ratings
  • D-SNP
  • Part-D
  • Audits
  • Appeals
  • Fee-For-Service

The detailed analysis can be found here. HMA will continue to monitor for new policy changes impacting Medicare. For more information, please email medicare@healthmanagement.com.

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