VBID: Watch Out: CMS Will Keep a Close Eye on VBID Participants
‘Secret shoppers’ are part of the federal government’s arsenal.
The new Value-Based Insurance Design (VBID) model for Medicare Advantage (MA) Plans appears to give plans a wide berth when redesigning benefits for targeted enrollees. But there are many safeguards in place, ensuring that the Centers for Medicare & Medicaid Services (CMS) will definitely be watching plans closely.
CMS has built into the model design a variety of protections for enrollees. Chiefly, MA Plans are not allowed to propose reductions in targeted enrollee benefits or increases in targeted cost-sharing amounts as VBID interventions. Also, MA Plans cannot discriminate...
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