Healthcare DIVE November 27, 2024
The Biden administration is attempting to push through a slew of reforms to the controversial MA program in its final months in power.
Dive Brief:
- The CMS on Tuesday proposed additional guardrails around Medicare Advantage plans’ prior authorization practices — including their use of artificial intelligence, amid rising concerns that algorithms are being used to improperly delay or deny care.
- The proposed rule also aims to improve provider directories, give regulators more oversight into how plans administer supplemental benefits and crack down on predatory marketing. It also puts new criteria in place for reporting medical loss ratios, important metrics of plan spending.
- It’s the same rule in which the Biden administration is seeking to allow Medicare to cover weight...
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