The Centers for Medicare & Medicaid Services (CMS) is asking for your help as it seeks to increase the transparency of the privately managed Medicare Advantage (MA) plans and to strengthen the program's data capabilities.
“Americans with Medicare who have managed care plans called Medicare Advantage should not feel like their health care is a black box,” Xavier Becerra, secretary of the Department of Health and Human Services, said in a statement. “The lack of transparency in Medicare Advantage managed care plans deprives patients of important information that helps them make informed decisions. It deprives researchers and doctors of critical data to evaluate problems and trends in patient care.”
To that end, the CMS has issued a request for information (RFI) for the public to give data-related input on all aspects of the Medicare Advantage program.
Sign up for Kiplinger’s Free E-Newsletters
Profit and prosper with the best of expert advice on investing, taxes, retirement, personal finance and more - straight to your e-mail.
Profit and prosper with the best of expert advice - straight to your e-mail.
Comments are due by May 29.
What is and is not working
While traditional Medicare — Parts A and B — covers a large portion of medical expenses after you turn 65, there are things Medicare doesn't cover, as Kiplinger has previously reported. This is where Medicare Advantage, a supplemental plan, can help.
The CMS said the information it gathers from the RFI will be used to strengthen its data capabilities and guide policymaking. The agency needs the data so that it can measure what is and is not working.
"In healthcare, you can't improve what you don't know, and the way to know is with data," said Dr. Meena Seshamani, CMS deputy administrator and director of the Center for Medicare.
The types of information requested includes data on access to care, prior authorization, provider directories and networks; supplemental benefits; marketing; care quality and outcomes; value-based care arrangements and equity; and healthy competition in the market, including the effects of vertical integration and how that affects payment.
Transparency is especially important, the CMS said, because Medicare Advantage enrollment has grown to more than 50% of Medicare enrollment. This puts the government on the hook for about $7 trillion in payments to Medicare Advantage health insurance companies during the next decade, it said.
The CMS said that the information solicited by the RFI will support its efforts to:
- Ensure MA plans best meet the needs of people with Medicare.
- Ensure that people with Medicare have timely access to care.
- Ensure that MA plans appropriately use taxpayer funding.
- Ensure that the MA market has healthy competition.
To access the RFI, visit the Federal Register’s webpage and follow the prompts.
Related Content
-
Visa Is the Worst Dow Stock Wednesday. Here's WhyVisa stock is down sharply Wednesday after the credit card company came up short of revenue expectations for its fiscal Q3.
-
Another Analyst Moves to the Sidelines on Tesla Stock After EarningsTesla stock is spiraling Wednesday after the EV maker's big earnings miss and Wall Street has been quick to weigh in. Here's what you need to know.
-
Visa, Mastercard's Swipe Fee Settlement Might Save You Money, For NowThe limited-time agreement directly benefits merchants, which can potentially pass savings on to consumers.
-
New List Out On Medicare Part B Drugs Eligible for RebatesSome Medicare beneficiaries may pay lower coinsurance rates from April 1 to June 30 for the drugs, HHS says.
-
Use An iPhone? You May Be Hearing From A Class-Action Lawsuit GroupA handful of suits against the iPhone maker seek to crack down on everything from app store purchases to messaging.
-
Capital One/Discover: What's In Their Wallet For You?Push back on Capital One's planned merger with Discover is growing with one group of consumer advocates calling for a public hearing.
-
Lawmakers: Nix Social Security Offsets For Seniors In Student Loan DefaultOffsetting Social Security benefits to pay for defaulted student loans can be devastating for some beneficiaries, lawmakers say.
-
Stellantis Recalls 285K Vehicles Over Airbag ProblemsDefective airbag inflators on certain Chrysler and Dodge vehicles could rupture and cause injury or death, NHTSA says.
-
HHS Funding Secured As Major Government Shutdown AvoidedWith passage of the fiscal 2024 appropriations package, Medicare and Social Security are among the key agencies to receive funding through September 30.
-
State Farm To Exit Homeowner Renewal Policies in CaliforniaState Farm plans to send non-renewal notices to 72,000 home and apartment policyholders starting this July.
