CMS Issues New Policies To Provide Greater Transparency For Medicare Advantage And Part D Plans
                     CMS ISSUES NEW POLICIES TO PROVIDE GREATER TRANSPARENCY FOR 
MEDICARE ADVANTAGE AND PART D PLANS
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CMS ISSUES NEW POLICIES TO PROVIDE GREATER TRANSPARENCY FOR 
MEDICARE ADVANTAGE AND PART D PLANS
The Centres for Medicare and Medicaid Services (CMS) are coming up with 
new policies to bring reforms in the healthcare industry. It is heralded as the 
final rule which aims at providing improved and better transparency for 
Medicare Advantage and Part D plans.
The new policies of the 2023 Medicare Advantage and Part D plans Final Rule 
push for affordable healthcare by reducing out-of-pocket charges for 
prescription drugs. However, that advantage will be in effect from 2024.
What Does The New CMS Policy Do?
The Biden – Harris administration has been committed to offering healthcare 
for all with quality and affordable care packages and this Final Rule is the 
extension of that. In fact, different areas have been worked on in the new 
CMS policy. 
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CMS ISSUES NEW POLICIES TO PROVIDE GREATER TRANSPARENCY FOR 
MEDICARE ADVANTAGE AND PART D PLANS
Some of CMS Policies are:
 Price Negotiation
 Uninterrupted Service
 Marketing Standards Revised
 New Standards For Application
 Medical Loss Ratio Reporting
 HEDIS
 Improved Coordination Between CMS & State
 Annual MA Assessment
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
CMS ISSUES NEW POLICIES TO PROVIDE GREATER TRANSPARENCY FOR 
MEDICARE ADVANTAGE AND PART D PLANS
Why Do The New Policy Changes Matter?
CMS released the new rule on the day the Office of Inspector General 
released an unflattering report on prior authorization denials by 
Medicare Advantage. The report stated that there had been a constant 
denial of payment for services that met the coverage rules of Medicare 
and the MAO billing.
As part of the process now, the government with the new rule wants to 
have a detailed understanding and report on where MA plans are using 
the government money. Therefore, the rules are re-established for 
better transparency and improved support that can be given to the 
social determinants of health.
It is believed that many dually eligible individuals are at much higher 
risk of failing to have the security of housing, food, access to 
transportation, and health literacy. In addition, since the work of CMS is 
fiscal stewardship, it needs to know where the Medicare money is used 
and on which Medicare Advantage benefits.
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CMS ISSUES NEW POLICIES TO PROVIDE GREATER TRANSPARENCY FOR 
MEDICARE ADVANTAGE AND PART D PLANS
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