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HHS/CMS | RIN: 0938-AT97 | Publication ID: Fall 2019 |
Title: Proposed Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Program for Contract Year 2021 (CMS-4190-P) | |
Abstract:
This proposed rule would implement changes to strengthen and improve the Medicare Advantage (Part C) and prescription drug (Part D) programs, and it would also implement related provisions of the Support for Patients and Communities Act. |
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Agency: Department of Health and Human Services(HHS) | Priority: Economically Significant |
RIN Status: Previously published in the Unified Agenda | Agenda Stage of Rulemaking: Proposed Rule Stage |
Major: Yes | Unfunded Mandates: No |
EO 13771 Designation: Other | |
CFR Citation: 42 CFR 422 and 423 | |
Legal Authority: 42 U.S.C. 1302 42 U.S.C. 1395hh Pub. L. 115-271 |
Legal Deadline:
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Overall Description of Deadline: Rule includes provisions of the "Support for Patients and Communities Act" required to be implemented by 01/01/2021. |
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Statement of Need: This rule is necessary to make revisions to the Medicare Advantage (MA or Part C) program, Medicare Prescription Drug Benefit (Part D) program, Medicaid program, Medicare Cost Plan program, and Programs of All-Inclusive Care for the Elderly (PACE) to implement certain sections of the Bipartisan Budget Act (BBA) of 2018, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, the 21st Century Cures Act, and other changes based on our continued experience in the administration of the programs. |
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Summary of the Legal Basis: This rule addresses multiple sections of the Social Security Act, the Bipartisan Budget Act of 2018, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, and the 21 st Century Cures Act. |
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Alternatives: This rule implements provisions that require public notice and comment and are necessary for the upcoming contract year. We will continue to explore additional alternatives as we develop the rule. |
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Anticipated Costs and Benefits: Preliminary estimates of the anticipated costs and benefits of this proposed rule indicate some savings and burden reduction for the government, MA organizations, prescription drug plan sponsors, and providers. Numerical estimates are pending as the Office of the Actuary is currently performing a detailed analysis of each provision. As we move toward publication, estimates of costs and benefits will be included in the proposed rule. |
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Risks: Risks of the proposals in this rule are still under development and will be included in the published rule for comment. |
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Timetable:
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Regulatory Flexibility Analysis Required: No | Government Levels Affected: None |
Federalism: No | |
Included in the Regulatory Plan: Yes | |
RIN Data Printed in the FR: No | |
Agency Contact: Heather Barkes Director, Division of Policy, Analysis, and Planning Department of Health and Human Services Centers for Medicare & Medicaid Services Center for Medicare, MS: C4-21-26, 7500 Security Boulevard, Baltimore, MD 21244 Phone:410 786-8615 Email: heather.barkes@cms.hhs.gov |