A June 20th memo alerts Medicare Advantage (MA) health plans they must notify the Centers of Medicare & Medicaid Services (CMS) by the end of the day Monday, June 24 if they intend to resubmit a bid or if they intend to opt out of resubmission.
Don’t miss your opportunity to alert CMS if your plan intends to resubmit your 2025 bid based on increased revenue associated with Tukey-related changes and the recalculation of 2024 Star ratings.
RELATED: CMS recalculates all 2024 MA Star ratings
The original memo on June 14 indicated that plans have until June 28 to resubmit the bids. A June 20th memo sent to MA organizations with the subject line “Additional Information on Bid Submissions for Updates to 2025 Quality Bonus Payment Determinations” updates the information, indicating that CMS needs advance notice by Monday, June 24 on whether plans intend to resubmit their bids based on higher 2024 Star ratings and additional quality bonuses.
Plans must send an email with the subject line: 2025 Bid Resubmission Decision Contract(s) HXXXX to the Part C & D Star ratings mailbox at PartCandDStarRatings@cms.hhs.gov by end of business today.
Special thanks to industry expert and RISE Fellow Melissa Smith for alerting RISE about the memo to notify plans. “I think many, many of our MA friends didn’t realize that they must submit revised bids to collect the new money after Tukey,” she told RISE.
In a LinkedIn post on Sunday, Smith included the memo with a message that “choosing not to submit a revised bid under these circumstances in order to collect the money your organization is legally entitled to is perhaps one of the highest-stakes business decisions I can recall in MA.” The bonus payments are not paid directly to plans. Rather, they are disbursed to plans through an adjustment to the benchmarked rates submitted in bids, she explained.
“Submitting a revised bid on a super short timeline (now down to just one more week) is hard. Requires an all-hands on deck fire drill. Potentially using vendors or consultants who you have to ask to work “off paper” with a promise to get contracts and payment in place after submission,” she wrote.
While it’s a huge effort to ask of your Star teams, Smith wrote she is concerned that many plans are choosing not to resubmit new bids and will forego the funding. That may be the easiest option for staff, but it is ultimately harmful to members and providers because 85 percent of the revenue has to flow back as medical loss ratio, she wrote.
“If your plan was impacted and you are reading this over the weekend, please don’t miss your opportunity. There is still time to add relatively simple, yet impactful adjustments, to your bid through a rapid revision before next week’s deadline to use the incremental revenue CMS’ adjustment provided to your contract(s) . . . Please don't miss your chance. Trust me. This IS your commitment to the best possible member experience. And since benefit erosion will hit on 1/1, this is your most critical MY2024 CAHPS decision. Your beneficiaries will thank you. Your providers will thank you. Your Board will thank you.”