CMS releases proposed rules for 2023 Medicare Advantage and Part D plans

Jan 07, 2022 - 03:06 PM
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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. 

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