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, which would strengthen data collection and reporting, MA appeals rights and processes, and network adequacy for behavioral health services. AHA also urged CMS to ensure that MA plans accurately report appeals measures data used to calculate star ratings and plan utilization management committees conduct an annual health equity analysis. In addition, AHA pressed CMS to make hospitals whole for past MA underpayments to 340B hospitals and establish guardrails on the use of AI tools that may facilitate automatic claim denials.