CMS Webinars on Rules Governing 3rd Year of Medicare Advantage-Hospice Demonstration

  • Recent Request for Applications from MA Plans for CY2023 to be addressed
  • Webinars on March 10, April 5

The Centers for Medicare & Medicaid Services (CMS) has scheduled two webinars in the near future to provide an overview of the CY2023 VBID-Medicare Hospice Benefit RFA. These webinars will allow time for audience questions.

On March 1, 2022, CMS released a Request for Applications (RFA) for Medicare Advantage (MA) plans interested in participating in the third year (CY2023) of the Hospice Benefit Component of the Value-Based Insurance Design Model (VBID). In addition to the RFA, CMS released other materials that may be of interest to MA plans and hospice providers, including a CY2023 VBID Model Fact Sheet and a memorandum providing the Calendar Year 2023 Preliminary Hospice Capitation Payment Rate Actuarial Methodology for the Hospice Benefit Component of the Medicare Advantage Value-Based Insurance Design Model.

Among the items of note included in the CY2023 RFA is the network adequacy methodology that CMS plans to use beginning in CY2023. CMS indicates in the RFA that Plan Benefit Packages (PBPs), a set of benefits for a defined MA service area, entering their second or later year of participation in the model must meet a Minimum Number of Providers (MNP) standard relative to contracted hospice programs. The MNP calculation is a modified version of the existing standard for MA network adequacy.

In addition to meeting the MNP standard, “mature” PBPs mut also provide coverage for out-of-network hospice services. Out-of-network providers will be paid at existing fee-for-services rates.

Additional details and analysis regarding the CY2023 RFA will be forthcoming from NAHC in a future edition of NAHC Report.

We urge you to put these two webinars on your calendar:

1. Webinar — Medicare Advantage Value-Based Insurance Design Model – 2023 Hospice Benefit Component Overview

WHEN:  Thursday, March 10, 2022, from 3 to 4 PM EASTERN

During this webinar, presenters will provide a brief review of the recently released Calendar Year (CY) 2023 Requests for Applications (RFAs) for the VBID Model and the Hospice Benefit Component as well as the payment design related to the Hospice Benefit Component of the VBID Model. This session will also offer attendees an opportunity to ask follow-up questions.

2. Webinar — Office Hours: Medicare Advantage Value-Based Insurance Design Model – 2023 Hospice Benefit Component Overview

WHEN: Tuesday, April 5, 2022, from 3 to 4 PM EASTERN

The CMS Innovation Center will host an office hours session to discuss the Medicare Advantage Value-Based Insurance Design (VBID) Model and its Hospice Benefit Component. Attendees will receive an overview of the Model and the CY 2023 application process, and have an opportunity for questions and answers with the Model team.