Medicare Advantage – Value-Based Insurance Design (VBID) Model – Application Process

Medicare Advantage – Value-Based Insurance Design (VBID) Model – Application Process

As Medicare Advantage Organizations (MAOs) are preparing their VBID Model applications, CMS encourages plans to reach out to the VBID Model team (VBID@cms.hhs.gov) with any questions, as well as any requests for technical support to assist with the application portal and process.

MAOs interested in applying to the VBID Model should fill out an application in the VBID application portal by March 15, 2019. MAOs may also choose to add components to their original application by 11:59 p.m. EDT on April 30, 2019. If the MAO wishes to amend its application with additional components, it must email the VBID Model team at VBID@cms.hhs.gov with:

• the application (contract, plan-benefit package, and VBID application number) that is being amended; and
• any proposed additions which will allow CMMI to help MAOs to clarify already submitted VBID components or submit new components.

MAOs that choose to make additions between the March 15th and April 30th timeframe may submit either a single, illustrative, revised CY 2019 bid pricing tool or a preliminary CY 2020 bid pricing tool, if available. MAOs should consult the VBID Model actuarial guidelines for the specific way to approach costs for the different components of the VBID model. Actuarial certification is not required for these preliminary submissions; formal review of VBID assumptions used in bids occurs as part of the June 3 bid submission process.

Any applications that are amended after the March 15, 2019 deadline will be granted provisional approval on a rolling basis before the June 3, 2019, prior to the CY2020 MA bid submission deadline. Best efforts will be made to review and provisionally approve amended applications in time for bid submission. Provisional approval means that MAOs are permitted to identify themselves as VBID Model participants and the timeline of the provisional approval will depend upon when a completed application is received.

Additionally, MAOs that intend to submit the same component(s) across multiple plan benefit packages (PBPs) may submit one application package that includes a list of all PBPs included as part of the test.

To stay up to date on the VBID Model, please visit our web page and sign up for CMS Innovation Center email alerts.

We encourage all interested stakeholders to reach out with questions. Please email us at VBID@cms.hhs.gov with questions or comments.