AHA Commended CMS for Increasing Oversight of Medicare Advantage Plans

• The AHA stated that CMS had taken significant steps to increase oversight of Medicare Advantage plans.   
• According to AHA, the CMS is working on new proposals. These proposal will tackle authorization barriers, and excessive marketing practices, among other issues.   
• The AHA mentioned they would continue to carefully review the proposed rule and support efforts to improve the Medicare Advantage program for patients and their providers.  

The American Hospital Association (AHA) commended the CMS for taking new and essential steps to increase oversight of Medicare Advantage plans. According to the association, these steps will help ensure enrollees have equal access to medically necessary healthcare services.     

In the statement, Ashley Thompson, AHA Public Policy Analysis & Development Senior Vice President, explained that the AHA has previously raised concerns about the adverse effects of certain Medicare Advantage practices and policies.   

All things considered, the statement explained that these policies have the potential to directly harm patients through unnecessary care delays or outright denial of covered services.   

Therefore,  the AHA commended CMS in the wake of new proposals. Generally,  these proposals will tackle prior authorization barriers and excessive marketing practices, among other issues.   

Specifically, this  new CMS proposed rule suggests revisions to regulations governing:  

• Medicare Advantage (MA or Part C).  
• Medicare Prescription Drug Benefit (Part D).  
• Medicare cost plans.  
• Programs of All-Inclusive Care for the Elderly (PACE).  

According to the CMS, this proposed rule includes policies that would improve beneficiary protections. They will also shore up guardrails that help CMS work to best meet the needs of beneficiaries.

In addition, “the proposed policies would increase access to care, including behavioral health services, and promote equity in coverage and care,” added the statement.  

Besides the AHA commended CMS, the association also mentioned that they would continue carefully reviewing the proposed rule. They also stated their support efforts to improve the Medicare Advantage program for patients and their providers.

Read the full CMS proposed rule here.  

For monthly updates, trends, and news, follow the AdvantEdge Linkedin page and visit our website.