An Advance Look at Medicare Advantage Benefits Changes for CY2022

Every year, the Centers for Medicare and Medicaid Services (CMS) updates its Plan Benefit Package (PBP) Software that Medicare Advantage (MA) and Part D plans use as part of their bid submissions. The PBP Beta Software is released in late January to allow plans to test and provide feedback before the full version is available for download via HPMS in April.

Included with the PBP Beta Software is a list of changes to each of its sections. As MA and Part D plans prepare for Contract Year (CY) 2022 bid submissions and materials, here are a number of important CY2022 Medicare Advantage benefits changes and PBP changes.

• 4a Emergency /Post-Stabilization Services has been renamed to “Emergency Services” (second year in a row for this service category’s name change)
• Combination benefit questions have been removed from 7b Routine Chiropractic, 13a Supplemental Acupuncture, and 14c Alternative Therapies
• 13c Meal Benefit:
  • Questions removed: “How many days does your Meal Benefit last?” and “What is the maximum number of meals the benefit provides?”
  • Replaced with the variable: “Select the type of primary health-related meals benefit offered.”
• 14c Therapeutic Massage questions added: “Is this benefit unlimited?”, “Indicate limit for number of sessions” and “Indicate number of sessions periodicity”
• 14c Support for Caregivers of Enrollees variable added: “Select the type of benefit offered”
• 14e Other MC Preventive Services benefit questions have been removed from the list of options for “Other Medicare-covered Preventative Services”

Every contract year, CODY^® analyzes the PBP Beta Software and makes updates to our data sources through the CodySoft^® Plan Benefit Package Module^® (PBP) to reflect the changes.

To find out how CodySoft^® products can help your health plan navigate the ever-changing healthcare landscape please contact us today for a consultation or a software demo.

About CODY: CODY^® works with more than 60 government-funded, commercial, and ACA health plans across 45 states and Puerto Rico. We help health plans improve regulatory compliance, manage plan benefit data, and streamline member/provider communications to maximize performance across the enterprise. CodySoft^®, our proprietary suite of software, is designed specifically for health plans. www.codyconsulting.com.