The Biden administration needs to do more to address the impact of the pandemic on Medicare Advantage enrollee risk scores, a key payer group charges.
The insurance lobbying group AHIP said in comments on the MA and Part D advance notice, which details payment rates and policies for the 2023 coverage year, that plans need more stability on calculating the risk scores that could be affected by the COVID-19 public health emergency. Groups also called for more standardization in how to collect and use social risk factor data to improve health equity.
AHIP was concerned that the Centers for Medicare & Medicaid Services (CMS) doesn’t detail in the advance notice the extent to which patients have delayed or forgone care due to the pandemic and how that has limited providers’ “ability to accurately and completely document enrollee healthcare conditions,” according to the group’s comments.
