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CMS Issues Proposed Rule for 2023 Medicare Advantage and Part D Plans

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The Centers for Medicare & Medicaid Services (CMS) has issued its proposed rule for the 2023 Medicare Advantage (MA) and Part D plan year.  

CMS proposes several policies related to agency oversight of health plans, including improved monitoring of network adequacy and transparency in medical loss ratio reporting requirements. CMS also seeks comments on several requests for information, including how MA plan prior authorization policies have impacted hospital transfer to post-acute care settings during the COVID-19 public health emergency, as well as MA enrollee access to behavioral health services.  

CMS also proposes policies related to dual-eligible special needs plans, MA star ratings, and calculating pharmacy costs for the purposes of beneficiary Part D cost-sharing. Comments on the proposed rule are due March 7, and more information is available in a CMS fact sheet.