CMS finalizes 2025 Medicare Advantage rule: 11 key updates

Becker's Healthcare April 5, 2024
Jakob Emerson

CMS issued its final 2025 Medicare Advantage and Part D rule April 4, setting new standards around marketing, broker payments, and prior authorization.

Here are 11 things to know about CMS’ final rule:

1. CMS set a fixed amount that agents and brokers can be compensated by MA plans, regardless of the plan a beneficiary enrolls in. The agency increased the final fixed amount by $100, compared to the proposed $31.
2. Personal beneficiary data collected by a third-party marketing organization for marketing or enrollment purposes may only be shared with another TPMO when prior written consent is given by the enrollee.
3. Insurers are generally prohibited from paying TPMOs volume-based bonuses for steering a certain number of enrollees to health...

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