Is it 2023 Already? Planning for Contract Year 2023 has Begun for Health Plans

Now that everyone has taken a moment to breathe and maybe a couple of days off after a successful launch of the contract year (CY) 2022 configuration, it’s time to begin planning for 2023.

Because the Centers for Medicare and Medicaid Services (CMS) Isn’t Waiting

CMS published the CY2023 Proposed Rule (CMS-4192-P) on January 12, the Advance Rate Announcement on February 2, and the CY2023 Medicare Parts C and D Annual Calendar via Health Plan Management System (HPMS) memo on February 9, marking the milestones for this year and into 2023.

While awaiting finalization of the Proposed Rule and Rate Announcement, we can already begin the 2023 configuration based on published requirements that are effective 1/1/2023 and identify areas that may require updating when the proposed rule and rate announcement are finalized in early April. Building on the partnerships we leveraged during the run-up to 2022 go-live, Elixir is kicking off CY2023 readiness meetings in mid-March.

Auditors Are Ready, Too

With the launch of the Payment Recovery Information System (PRIS) Plan Portal, CMS has made clear that plan sponsors can expect more in the way of Self-Audits and Elixir stands ready to continue to support clients if, and when, CMS issues those engagement letters.

CMS began sending engagement letters to initiate routine audits in February 2022 and will continue through July 2022—opening that window a month earlier than past years—and may send engagement letters for ad hoc audits at any time during the year.

Elixir’s Clinical Audit team has delivered annual reporting to all plan sponsor clients, is completing reviews in advance of data validation audits and, of course, is looking ahead to program audits that CMS may initiate during 2022. Reporting templates are complete and ready in accordance with CMS audit protocols.

While 2022 has just begun and it may seem overwhelming to start planning for 2023 already, Elixir is taking the needed steps to be prepared and assist our clients so we can get there together. The planning has begun and we are energized for the year to come!