CMS Issues Advance Notice on CY 2009 Medicare Advantage Capitation Rates

In a February 22, 2008 Memorandum, the Centers for Medicare & Medicaid Services (CMS) issued an advance notice of proposed changes to the Medicare Advantage (MA) capitation rate methodology and risk adjustment methodology under the Medicare Part C program for calendar year (CY) 2009.

In Attachment I of the Memorandum, CMS indicates that the current estimate of the change in the national per capita MA growth percentage for aged and disabled enrollees combined is 4.8 percent for CY 2009. According to CMS, this estimate reflects an underlying trend change in per capita costs of 3.4 percent for CY 2009, and adjustments to the estimates for aged and disabled growth percentages for CYs 2004-2008.

In Attachments II-V of the Memorandum, CMS also addresses:

• changes in payment methodology for CY 2009 for original Medicare benefits
• changes in payment methodology for CY 2009 for Part D benefits
• preliminary CMS-HCC risk adjustment factors
• annual adjustments for 2009 for the Part D benefit parameters for the defined standard benefit

The final rates will be announced on April 7, 2008 in the Announcement of Calendar Year 2009 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies.  In order to be considered, comments must be received by 6:00 p.m. (EST) on March 7, 2008.  The Memorandum and a related Fact Sheet contain information regarding the submission of comments to CMS.