Illustration: Maura Losch/Axios
CMS finalized a rule Wednesday to increase oversight of Medicare Advantage and Medicare prescription drug plan marketing.
- The rule also clarifies when and how plans can use prior authorization, following last year’s OIG report suggesting MA plans sometimes deny beneficiaries access to medically-necessary care.
Why it matters: The Senate Finance Committee and other lawmakers have called on CMS to increase oversight of “deceptive” Medicare Advantage marketing tactics.
The details: CMS finalized 21 out of 22 proposed provisions to rein in Medicare Advantage marketing. Four of the finalized proposals included slight modifications from the earlier policy draft.
The big picture: The finalized marketing policies are part of a Biden administration kick to rein in bad actors in the Medicare Advantage program.
- Last week, CMS finalized a change to Medicare Advantage payment that plans also claimed would raise premiums and reduce benefits — but the agency gave plans a major concession by phasing the payment changes in over three years.
