Proposed MA Rule Floats Many Star Ratings Changes — Can Plans Keep Up?

In addition to codifying previous policy changes and extending some new flexibilities to Medicare Advantage organizations, a recent 900-page proposed rule (85 Fed. Reg. 9002, Feb. 18, 2020) from CMS contains some significant changes to the star quality ratings. And while CMS is giving plans plenty of lead time to prepare for proposed modifications that would take effect with the 2021 measurement year, it may be hard for plans to keep up with the sheer volume of planned changes, suggests Melissa Smith, senior vice president of stars & strategy at Gorman Health Group, LLC.

“I think the good news is that CMS is delivering on its promise for transparency and stability and plenty of warning,” says Smith, referring to a 2019 final rule that codified key aspects of the Parts C and D star ratings rather than allowing CMS to continually make retroactive changes to measures (RMA 4/5/18, p. 7).

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Lauren Flynn Kelly

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.

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