The Centers for Medicare & Medicaid Services will closely monitor Medicare Advantage and Part D plans for compliance with new requirements effective Jan. 1 to ensure timely access to care, medications and vaccinations, the agency warned plans and pharmacy benefit managers Dec. 14. 

“We remind plans that CMS will be conducting robust oversight to ensure Medicare Advantage organizations are complying with these new requirements, and we continue to review comments received on the additional proposals from the second rulemaking,” the letter notes. Among other concerns, CMS said, “We urge plans and PBMs to engage in sustainable and fair practices with all pharmacies – not just pharmacies owned by PBMs – and we are closely monitoring plan compliance with CMS network adequacy standards and other requirements.”

AHA has urged CMS to swiftly correct plans that appear to violate the MA final rule for calendar year 2024. 

Related News Articles

Headline
The Department of Health and Human Services and the Centers for Medicare & Medicaid Services Aug. 21 announced the creation of a Healthcare Advisory…
Headline
A JAMA study published Aug. 18 found that plan design changes by Medicare Part D insurers, particularly for Medicare Advantage plans, following passage of the…
Headline
The House Ways and Means Subcommittees on Health and Oversight held a joint hearing today to discuss lessons learned, challenges and opportunities to improve…
Headline
The AHA July 3 released the Health Care Plan Accountability Update for the second quarter of 2025. The update covers the latest developments in Medicare…
Headline
The Departments of Justice and Health and Human Services today announced the creation of the DOJ-HHS False Claims Act Working Group to combat health care fraud…
Headline
The Department of Health and Human Services June 23 announced an initiative coordinated with multiple health insurance companies to streamline prior…