The Centers for Medicare & Medicaid Services Friday finalized policy and technical changes to the Medicare Advantage and prescription drug benefit for contract year 2023. To improve MA plan oversight, the final rule would reinstate plan reporting on medical loss ratio requirements that were relaxed in 2017; require plans to demonstrate a sufficient provider network when applying for a new or expanded contract; strengthen CMS’s ability to evaluate plan performance when reviewing proposals for new or expanded contracts; require plans to provide certain materials to beneficiaries in culturally and linguistically appropriate ways; and strengthen oversight of third-party marketing organizations, among other consumer protection provisions. The rule also codifies provisions intended to improve and better assess quality for special needs plans that serve beneficiaries dually eligible for Medicare and Medicaid. 

Related News Articles

Headline
The AHA Oct. 23 recommended changes to the Centers for Medicare & Medicaid Services’ Wasteful and Inappropriate Services Reduction model to address…
Headline
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…
Headline
Medicare open enrollment for 2026 began Oct. 15 and runs through Dec. 7. During the annual enrollment period, Medicare-eligible individuals can check their…
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…