MedPage Today April 6, 2023
— Agency wants to stop schemes that mislead beneficiaries and prohibit unfair denials of care
CMS finalized a rule Wednesday that will limit the ability of Medicare Advantage (MA) plans to deny or delay care through prior authorization processes and will impose tight restrictions on how such plans can be marketed to limit “misleading, inaccurate, and/or confusing” claims.
The 724-page rule, which aims to strengthen beneficiary protections, also sets forth requirements that MA plan provider directories include each clinician’s cultural and linguistic capabilities and expects those plans to develop digital health education programs for enrollees with low digital health literacy to help them access telehealth services.
MA plans must also include distance and minimum number requirements for two provider categories...
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