The move contrasts with shorter timelines associated with the releases of the IPPS, OPPS rules.
In an apparent effort to make providers’ lives a little easier, federal officials earlier this week issued Part I of the 2022 Medicare Advantage (MA) Advance Notice of proposed payment changes.
“This announcement of Medicare Advantage and Part D payment methodologies is being made approximately three months earlier than usual to provide Medicare Advantage organizations and Part D sponsors more time to take this information into consideration as they prepare their bids for 2022,” the Centers for Medicare & Medicaid Services (CMS) said in a press release. “The earlier release will help Medicare Advantage and Part D plans to better address estimating 2022 plan costs, in light of the uncertainty associated with the COVID-19 pandemic.”
CMS updates the methodology used to calculate payments made to MA and Part D plans through the agency’s Advance Notice and Rate Announcement process. Part I includes information about Medicare Advantage risk adjustment for 2022, with a 60-day comment period expiring in November.
Other changes to payment methodologies for 2022 that are typically contained in the Advance Notice Part II only require a 30-day comment period, and will be released at a later time, CMS noted. The MA and Part D payment policies for 2022, outlined in both Part I and Part II of the Advance Notice, will be finalized in the 2022 Rate Announcement – published no later than April 5, 2021.
The move contrasts with tighter CMS publication deadlines seen during recent months – for example, when the agency released the Changes to Hospital Outpatient Prospective Payment System (OPPS) for the 2021 calendar year (CY) back in August, with comments due by Oct. 5, CMS also noted that it was waiving the 60-day publication requirement for the Final Rule, instead replacing it with a 30-day notification. In other words, although the final rule will become effective Jan. 1, 2021, it may not be published until Dec. 1, instead of the typical Nov. 1 target date.
A similar announcement coincided with the Inpatient Prospective Payment System (IPPS) Final Rule for the 2021 fiscal year (FY), with a 60-day publication window also reduced to 30 days.
To review a fact sheet on Part I of the 2022 Advance Notice, go online to: https://www.cms.gov/newsroom/fact-sheets/2022-medicare-advantage-advance-notice-part-i-risk-adjustment
To view Part I of the 2022 Advance Notice, go online to https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Announcements-and-Documents.html and select “2022.”
In the last six weeks, my colleagues and I have dealt with two situations in which clinics either missed or did not receive the orange
Modern Healthcare reported that UnitedHealthcare (UHC) says that starting Jan. 1, it will only pay for remote patient monitoring for heart failure or hypertensive disorders
Please log in to your account to comment on this article.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
As AI reshapes healthcare compliance, the risk of biased outputs and opaque decision-making grows. This webcast, led by Frank Cohen, delivers a practical Four-Pillar Governance Framework—Transparency, Accountability, Fairness, and Explainability—to help you govern AI-driven claim auditing with confidence. Learn how to identify and mitigate bias, implement robust human oversight, and document defensible AI review processes that regulators and auditors will accept. Discover concrete remedies, from rotation protocols to uncertainty scoring, and actionable steps to evaluate vendors before contracts are signed. In a regulatory landscape that moves faster than ever, gain the tools to stay compliant, defend your processes, and reduce liability while maintaining operational effectiveness.
Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
