January 31, 2024
WASHINGTON, DC — The following statement in response to the Calendar Year 2025 Advance Notice for the Medicare Advantage and Medicare Part D Prescription Drug Programs released today by the Centers for Medicare & Medicaid Services (CMS) can be attributed to Susan Dentzer, President and CEO, America’s Physician Groups (APG).
“We are still digesting the newly released Advance Notice in detail, but an initial read suggests that CMS is continuing to implement as planned the changes it put in place last year in risk adjustment and other aspects of the Medicare Advantage (MA) program. This continuity of effort suggests that there will be greater stability in the program into 2025 than might have been the case otherwise. APG is grateful for this stability, as it will enable our members’ groups – who care for about 1 in 3 individuals enrolled in MA – to do the best possible job of caring for their patients.
“We also welcome the rules implementing provisions of the Inflation Reduction Act, such as the $35 monthly limit on patient copayments for insulin products and the $2,000 cap on out-of-pocket payments in Part D. These provisions will now be fully incorporated into MA plans that offer Part D benefits. This positive development will make it possible for millions of MA enrollees to have access to medications at reasonable out-of-pocket costs and further enable our APG members to take better care of them.
“We look forward to delving further into the Advance Notice; educating our members about it; and responding with our comments to CMS.”
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About America’s Physician Groups
APG’s approximately 360 physician groups comprise 170,000 physicians, as well as thousands of other clinicians, providing care to nearly 90 million patients. APG’s motto, ‘Taking Responsibility for America’s Health,’ represents our members’ commitment to clinically integrated, coordinated, value-based health care in which physician groups are accountable for the costs and quality of patient care. Visit us at www.apg.org.
Contact: Greg Phillips, APG Director of Communications, 202-770-1901