Fierce Healthcare October 1, 2021
Mark Switaj

In 2019, the Centers for Medicare & Medicaid Services (CMS) increased flexibility for Medicare Advantage (MA) plans by redefining “primarily health-related” supplemental benefits for MA members.

“[A primarily health-related benefit] must diagnose, prevent, or treat an illness or injury, compensate for physical impairments, act to ameliorate the functional/psychological impact of injuries or health conditions, or reduce avoidable emergency and healthcare utilization,” the agency said.

CMS’ new definition emphasizes an underutilized benefit: transportation.

Not only can transportation be used for critical care services, but also for preventive services, pharmacy visits, massage therapy, fitness centers and other healthcare-related destinations. As a result of increased flexibility, more than 1,900 MA plans are offering nonemergency medical transportation benefits, according to the Medical Transportation...

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Topics: CMS, Equity/SDOH, Govt Agencies, Healthcare System, Insurance, Medicare Advantage, Patient / Consumer, Payer, Provider
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