The Centers for Medicare & Medicaid Services yesterday released proposed regulations for the 2023 Medicare Advantage and Part D plan year. Notably, the proposed regulations include a number of changes to increase agency oversight of health plans, including provisions to better monitor provider networks and compliance with the medical loss ratio requirements, as well as stronger oversight of third parties that help beneficiaries choose and enroll in MA and Part D plans. Also of importance to hospitals and health systems are requests for information related to: MA prior authorization policies and their effect on patient access to care and health system capacity during a public health emergency; and enrollee access to behavioral health services. CMS proposes a number of other policies related to special needs plans, as well as how pharmacy costs are calculated for purposes of beneficiary cost-sharing at the point of service. Comments on the rule are due March 7. 

Related News Articles

Headline
The AHA Oct. 3 responded to the Medicare Payment Advisory Commission’s recent analysis on the financial impacts of Medicare Advantage enrollment growth on…
Headline
The Centers for Medicare & Medicaid Services Sept. 30 issued a memo, through the Health Plan Management system, finalizing the Medicare Advantage…
Headline
The AHA Sept. 29 sent recommendations to the Department of Health and Human Services and the Centers for Medicare & Medicaid Services to help ensure…
Headline
The Centers for Medicare & Medicaid Services announced Sept. 26 that average premiums for Medicare Advantage and Part D would decline slightly in 2026.…
Headline
The AHA expressed support Sept. 22 to House and Senate sponsors of the Medicare Advantage Prompt Pay Act (H.R. 5454/S. 2879), legislation that would apply a…
Headline
The Centers for Medicare & Medicaid Services Sept. 18 released a final rule on policy and technical changes to Medicare Advantage, the Medicare…