Lexology November 13, 2023
On November 6, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released the contract year 2025 proposed rule for Medicare Advantage (“MA”) organizations and Part D sponsors (the “Proposed Rule”). The Proposed Rule covers an array of regulatory topics including the Star Ratings program, marketing and communications, agent and broker compensation, health equity, dual eligible special needs plans (“D-SNPs”), utilization management, network adequacy, and access to biosimilars.
Below is a summary of some of the Proposed Rule’s key changes.
Improving Access to Behavioral Health Care Providers
The Proposed Rule would expand MA network adequacy requirements to encompass outpatient behavioral health in order to improve access to behavioral health care providers. As part of its Behavioral Health Strategy, CMS aims...
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