Lexology December 9, 2024
Ropes & Gray LLP

On November 26, 2024, Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule revising the Medicare Advantage (“MA”) Program (Part C), Medicare Prescription Drug Benefit Program (Part D), Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly (PACE).

Among other goals, the proposed rule for Contract Year 2026 aims to enhance accountability for MA and Part D plans to protect Medicare beneficiaries’ access to care. To the extent this proposed rule is finalized, healthcare providers and plans will be required to adapt their marketing strategies in significant ways, which can increase the risk of enforcement (especially for marketing-related changes) and carry substantial operational and compliance costs in six key areas, each of which is summarized...

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Topics: CMS, Govt Agencies, Insurance, Medicare Advantage
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