KFF April 10, 2024
The Centers for Medicare and Medicaid Services (CMS) has recently taken actions to increase transparency in Medicare Advantage, the private plan alternative to traditional Medicare that now provides Medicare coverage to more than half of all eligible Medicare beneficiaries. In particular, the agency has clarified and expanded reporting requirements for Medicare Advantage insurers pertaining to use of supplemental benefits that may be available to researchers and others upon request within a few years. In addition, CMS is requiring Medicare Advantage insurers to post summary data on the timeliness and use of prior authorization on their own websites beginning in 2026.
Payments to Medicare Advantage insurers are both higher and growing faster than spending in traditional Medicare. In 2024, MedPAC estimates...