The Medicare Payment Advisory Commission unanimously backed recommendations that would reduce Medicare Advantage plan reimbursement by at least $200 million.

The suggestions involve allowing the HHS secretary to eliminate benchmark caps and the “double bonuses” now received by Medicare Advantage plans. The current payment formula uses outdated spending calculations from 2010, according to Scott Harrison, a principal policy analyst at MedPAC. The Affordable Care Act allows some counties to receive double quality bonuses if they are in metropolitan areas with at least 250,000 people. About 19% of Advantage enrollees are in double-bonus counties, and 19% are in capped counties. MedPAC will formally vote on the recommendations in January and present its findings to Congress by March.