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CMS continues to press MA plans 

CMS continues to press MA plans  Agency also recently released payment policy outlining a 3.7% increase in payments 

WASHINGTON – CMS has finalized policies that it says will continue to strengthen protections and guardrails to ensure Medicare Advantage and Medicare Part D prescription drug plans best meet the needs of enrollees. 

The Contract Year 2025 Medicare Advantage and Part D final rule will: 

  • Establish a set amount a plan can compensate an agent or broker to protect Medicare Advantage and Part D plan enrollees and prospective enrollees from anti-competitive steering. 

  • Require that Medicare Advantage plans include an expert in health equity on their utilization management committees and conduct an annual health equity analysis of their prior authorization policies and procedures. 

  • Finalize new guardrails for certain types of supplemental benefits, available only to chronically ill enrollees, to ensure they meet the health needs of enrollees and are supported by evidence and require plans to send a mid-year, personalized communication to their enrollees about accessing unused supplemental benefits. 

“CMS is continuing its commitment to ensuring that Medicare Advantage and Part D prescription drug plans remain strong, stable, and affordable for people with Medicare,” said CMS Administrator Chiquita Brooks-LaSure. “This final rule builds on Biden-Harris Administration efforts to strengthen consumer protections so that people with Medicare can more easily choose the Medicare coverage options that are right for them.” 

View a fact sheet on the final rule here


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