CHA has issued a detailed summary, prepared by Health Policy Alternatives, on the Centers for Medicare & Medicaid Services’ (CMS) proposed changes to Medicare Advantage (MA) as well as the Medicare Prescription Drug Benefit Program, Medicaid Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly.
Policies included in the proposed changes for MA plans are:
- Network adequacy standards intended to incentivize MA plans to expand access to telehealth services
- The medical loss ratio methodology
- The MA star ratings (increasing the weight of beneficiary experience, complaints, and access)
- Codification of previously adopted supplemental benefit requirements
- Policies intended to address concerns related to dual-eligible special needs plans (D-SNPs) “look-alikes,” and procedures to transition these enrollees to other MA plans
For Part D plans, CMS proposes to expand drug management programs and medication therapy management programs, and require Part D plans to educate beneficiaries on opioid risks, alternate pain treatments, and safe disposal of opioids.
CHA is currently reviewing the proposed rule. Comments are due to CMS by 2 p.m. (PT) on April 6.