The CMS proposal for 2020 would give plans more flexibility to cover supplemental benefits for people with chronic illnesses, including those suffering from chronic pain or undergoing treatment for addiction.
Medicare Advantage plans would gain even more flexibility next year to provide supplemental benefits to beneficiaries with chronic illnesses, under the terms of a proposal announced Wednesday by the Centers for Medicare & Medicaid Services.
Demetrios Kouzoukas, principal deputy administrator for Medicare and director of the Center for Medicare, said in a call with reporters that the proposal would allow any benefit that improves or maintains healthcare and could enable plans to reduce cost-sharing.
While CMS isn't requiring plans to provide these added benefits, it would allow them to elect to cover additional services, such as home-delivered meals, Kouzoukas said.
The announcement came with the release of the second part of CMS' 2020 Advance Notice and Draft Call Letter.
This comes after CMS allowed more supplemental benefits for 2019 and Health and Human Services Secretary Alex Azar hinted in a speech last fall that additional flexibility would be forthcoming.
"How can someone manage diabetes if they are constantly worrying about how they’re going to afford their meals each week?" Azar said in prepared remarks at the Hatch Foundation for Civility and Solutions last November.
"How can a mother with an asthmatic son really improve his health if it’s their living environment that’s driving his condition?" Azar added. "This can feel like a frustrating, almost fruitless position for a healthcare provider, who understands what is driving the health conditions they're trying to treat, who wants to help, but can’t simply write a prescription for healthy meals, a new home, or clean air."
Related: Azar Outlines HHS Ambition on Social Determinants of Health: 5 Takeaways
In a statement Wednesday, CMS Administrator Seema Verma said enrollment in Medicare Advantage plans "is at an all-time high" and that policymakers "need to maximize competition" by allowing for added flexibility.
The letter also proposed rates for MA plans next year, with an average 1.59% rate increase. The increase does not include a 3.3% expected average increase in risk scores, due to an underlying coding trend, according to a CMS fact sheet.
Comments on the proposal will be accepted until March 1, with an estimated finalization date on or before April 1.
Steven Porter is an associate content manager and Strategy editor for HealthLeaders, a Simplify Compliance brand.