Becker's Healthcare December 16, 2024
Rylee Wilson

Medicare Advantage plans must comply with new network adequacy and health equity standards in 2025.

Here are five policy changes taking effect in 2025:

  1. CMS will require Medicare Advantage plans to meet new standards for behavioral health network adequacy in 2025. Plans will be required to meet standards for access to outpatient behavioral health providers, including marriage and family therapists, mental health counselors and opioid treatment providers.
  2. Beginning in 2025, Medicare Advantage plans must include a health equity expert on panels reviewing prior authorization requirements. In addition, MA insurers will have to evaluate the effect their prior authorization policies have on health equity.
  3. Plans will be required to send enrollees a mid-year notice to enrollees, listing any...

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Topics: Insurance, Medicare Advantage
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