By RaeAnn Grossman

On April 1, 2019, CMS released the final call letter for 2020 along with a fact sheet.  The Advance Notice was shared in two parts: Part I on December 20, 2018, and Part II on January 30, 2019, with the Draft Call Letter. As is CMS’ normal process, they accepted comments on the Advance Notice through March 1, 2019. The objective will be to continue to drive competition among Medicare Advantage and Part D plans, as well as include important actions to explain supplemental benefits, amend STAR measures, address the nation’s opioid crisis, and increase the use of encounter data to value risk adjustment impact. CMS currently wants to increase the amount and weight of encounter data from 25% to 50%. This is a challenge for many health plans, as encounter data is often inaccurate and incomplete. This may cause risk adjustment scores to lower which may impact Medicare Advantage health plan payments.

The CMS final call letter for 2020 again makes health plans and provider data aggregation, effective care visits, coding, and data management critically important.