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OIG says MA, Medicaid managed care plans have limited, inaccurate behavioral health provider networks
A report by the Department of Health and Human Services Office of the Inspector General found that many Medicare Advantage and Medicaid managed care plans offer access to a limited proportion of behavioral health providers, and inaccurately list 72% of in-network behavioral health care providers as being available.
GAO says CMS should target behavioral health services in prior authorization audits
The Government Accountability Office May 29 released a report recommending the Centers for Medicare & Medicaid Services target behavioral health services when auditing Medicare Advantage plans’ use of prior authorization.
AHA-supported bill would repeal discriminatory Medicare policy
The AHA today expressed support for the Medicare Mental Health Inpatient Equity Act, a bill that would eliminate the 190-day lifetime limit on inpatient psychiatric hospital services for Medicare patients.
CMS releases final rule for 2026 Medicare Advantage, prescription drug plans
The Centers for Medicare & Medicaid Services April 4 finalized changes to the Medicare Advantage and prescription drug programs for contract year 2026.
AHA supports policy, technical changes to Medicare Advantage, Part D for 2026
The AHA Jan. 27 voiced support for the Centers for Medicare & Medicaid Services proposed rule on policy and technical changes to Medicare Advantage and Part D for contract year 2026.
OIG report finds just 40% of Medicare enrollees who started treatment for opioid use disorder continued
The Department of Health and Human Services Office of Inspector General Feb. 18 released a report that found about 40% of Medicare enrollees who began opioid use disorder treatment with buprenorphine continued with it for at least six months in office-based settings.
AHA comments on proposed Medicare Advantage policies for 2025
AHA Jan. 5 voiced strong support for Centers for Medicare & Medicaid Services proposals to increase oversight and enhance consumer protections in the Medicare Advantage program for contract year 2025.
CMS releases proposed rule for 2026 Medicare Advantage, prescription drug plans
The Centers for Medicare & Medicaid Services Nov. 26 proposed changes to increase oversight of the Medicare Advantage and prescription drug programs for contract year 2026.
CMS finalizes rule for 2025 Medicare Advantage, prescription drug plans
The Centers for Medicare & Medicaid Services April 4 finalized changes to the Medicare Advantage and prescription drug programs for contract year 2025 intended to improve access to behavioral health care; cap and standardize MA plan compensation to brokers, including prohibiting volume-based bonuses for enrollment into certain plans; limit the distribution of personal beneficiary data by third-party marketing organizations; ensure that MA plans offer appropriate supplemental benefits; streamline enrollment for individuals dually eligible for Medicare and Medicaid; and annually review MA utilization management policies for health equity considerations.