Managed Healthcare Executive March 22, 2022
The proposed rules might ratchet down drug costs for Medicare beneficiaries and would set network adequacy standards.
In January, CMS proposed rules that would, among other changes, require health insurers to be more transparent, to lower out-of-pocket costs for prescription drugs and to improve patient outcomes.
In an extensive proposal taking up more than 115 pages in the Federal Register, CMS proposed changes in 14 areas, including new regulations on how Medicare Advantage (MA) and Medicare Part D plans establish networks, report medical-loss ratio (MLR) data, assess members’ risks for social determinants of health, and conduct appeals, marketing and communications.
If approved as proposed, the rule — CY 2023 Medicare Advantage and Part D Proposed Rule (CMS-4192-P) — would require...
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