On December 14, 2022, the Biden administration released a proposal to streamline Medicare Advantage (MA) and Part D plan prior authorization and add health equity requirements to star ratings. The Centers for Medicare & Medicaid Services (CMS) released a proposed rule outlining policies for MA and...
2023, revising the regulations governing marketing by Medicare Advantage plans (MAPs) and Medicare Part D plans (PDPs). These changes follow CMS’s October 2022memoexpressing concern regarding MAP and PDP marketing practices, and theproposed rule issued on December 14, 2022. The changes...
4月4日,美国医保局(CMS)发布了2025年的Medicare Advantage和Medicare Part D的最终版规则,其中对生物类似药替代的要求明显降低,Medicare Part D的所有生物类似药替换不再明确要求CMS的提前批准,而此前这一原则仅适用于可互换的(interchangeable)生物类似药。 在此之前,任何生物药处方的变更中,CMS规定保险公司、PBM或...
CMS reins in Medicare Advantage plansis a new online resource designed to meet the evolving needs of physicians. It brings together elements from Advanstar's trusted healthcare journals along with powerful tools, resources, decision support and advisory functions.Reid Paul...
On January 6, 2022, the Centers for Medicare & Medicaid Services (“CMS”) issued a proposed rule entitled “Medicare Program; Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs” (the “2022 Proposed Rule...
As Medicare Advantage premiums remain generally stable, more than 1,500 plans representing 8.7 million beneficiaries will participate in the CMS Innovation Center’s Medicare Advantage Value-Based Insurance Design (VBID) Model in 2024. The model improves access to supplemental benefits th...
Medicare Advantage Plans Onerous Prior Authorizations Requirements & Negative Impacts on Skilled Nursing Facilities Stotler Hayes Group, LLCon2/17/2025 Traditional Medicare (Parts A and B) and Medicare Advantage (Part C, including additional vision, dental, and hearing benefits) plans aim to provide ...
CMS has released itsfinal rulefor Contract Year 2022 Medicare Advantage and Part D which requires Part D plans to offer a real-time benefits comparison tool. The agency estimated that the rule’s alterations would save the federal government $75.4 million over the course of th...
plans to regularly review and mitigate the impact of biased data inputs. In addition, the proposed rule emphasizes that if MA plans utilize AI tools or automated systems, they must ensure that the usage of such tools complies with all existing Medicare policies ...
For Medicare Advantage plans, the average monthly premium will decrease from $18.23 in 2024 to $17 in 2025, continuing a trend of declining premiums over recent years, said CMS. This reduction, the agency said, reflects not only its payment policy updates, but also the sustained competit...