Hi partners,

As you may have heard, yesterday, CMS finalized their 2025 Rate Announcement for the Medicare Advantage Program. You can read the official rate announcement here.

In the finalized rate announcement, CMS and HHS continued implementation of its new risk adjustment model that will help begin to rein in the systematic coding abuses among MA plans, which are driving billions in overpayments and undermining the ability of CMS to hold MA plans accountable to delivering high quality, affordable, and equitable care.

While we applaud CMS for taking these important steps, at the same time, we also recognize that more needs to be done! It is important to note that the new risk adjustment model does not fully address nor rein in the differences in MA coding intensity and upcoding relative to Traditional Medicare. As a result, we need to continue to urge CMS and HHS to do more to hold MA plans accountable and mitigate the resulting harms to Medicare patients and taxpayers.

For awareness, Families USA submitted a public comment in advance of this announcement, which you can find here. We plan to send out a sign-on letter soon, lifting up the Administration’s work to hold MA plans and organizations accountable, while also calling on them to do more to rein in the corporate coding abuses found across the MA program.

If you are engaged in Medicare Advantage work or would like to talk to us further about getting involved, please reach out and we’d be happy to set up a time to chat.

Thank you,

Jamie Stevenson