Fierce Healthcare November 6, 2023
The Biden administration is once again cracking down on Medicare Advantage (MA) marketing tactics with new guidelines to promote healthy competition in the market and impose limits on plans’ payments to brokers.
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule Monday that outlines requirements to combat predatory MA marketing payment practices and improve access to behavioral health care as well as the inclusion of an expert in health equity on health plan utilization management committees to curb prior authorization rates.
The agency said it is concerned MA plans compensate agents and brokers with excessive compensation and bonus arrangements that circumvent existing payment rules, sometimes leading enrollees to plans that don’t best meet their healthcare needs. In...
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