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CMS: Health plans for dialysis patients on Medicare Advantage not impacted by sequester
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Although dialysis clinics are dealing with a 2% cut off the bundled rate for all Medicare patients because of federal sequestration, the cuts do not impact other Medicare programs, including Medicare Advantage.
The Centers for Medicare & Medicaid Services issued a memorandum last month affirming that Medicare Advantage Plans are exempt from the 2% cut. Part D plans are also exempt. Some insurance plans, including United Healthcare, Humana, and Anthem Blue Cross Blue Shield, had notified care providers that they should expect a 2% cut, according to Lexology, an industry newsletter published in cooperation with the Association of Corporate Counsel.
“Whether and how sequestration might affect payments to [an MA Plan] to its contracted providers are governed by the terms of the contract between the [MA Plan] and the provider,” CMS wrote in the May 1 memo. The agency said the same approach applies to payers managing a Part D plan.