CMS Seeks More Control Over Medicare Advantage Plans

The Centers for Medicare and Medicaid Services (CMS) is seeking public comment before it submits a proposal for more review power over Medicare Advantage plans in order “to provide adequate access to covered services to meet the needs of the population served.”

The CMS says it will submit the broader review plan to the Office of Management and Budget (OMB) on Aug. 18 for approval.

Currently, the CMS only reviews Medicare Advantage plan networks when there is a triggering event, such as a complaint filed or a new plan’s being launched. In January, the CMS said 45 percent of Medicare Advantage network lists contained incorrect information, including which providers were taking new patients, wrong phone numbers and wrong addresses.

NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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