Rule on Medicare Advantage, Part D reduces provider burden

The Centers for Medicare and Medicaid Services on Monday continued its efforts to reduce overly burdensome regulations on providers to enable them to spend more time taking care of patients and less time on paperwork.

As part of its Patients Over Paperwork initiative, CMS has issued a final rule that updates Medicare Advantage (MA) and the prescription drug benefit program (Part D) for contract year 2019 by simplifying documentation requirements.

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“Some of the specific changes we are finalizing include streamlining the review and approval process of materials that communicate Medicare health and drug plan information to beneficiaries, allowing electronic delivery of more materials to beneficiaries and improving transparency in our Star Ratings to give our beneficiaries reliable information about each Medicare Advantage plan quality rating so that they can choose a plan that’s right for them,” says CMS Administrator Seema Verma.

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Seema Verma, Centers for Medicare and Medicaid Services administrator nominee for U.S. President Donald Trump, speaks during a Senate Finance Committee confirmation hearing in Washington, D.C., U.S., on Thursday, Feb. 16, 2017. Verma, the businesswoman Trump selected to oversee Medicaid, the health care program for 74 million low-income Americans, has said the program is structurally flawed by policies that burden states and foster dependency among the poor. Photographer: Pete Marovich/Bloomberg

In particular, the final rule reduces regulatory burdens by:

  • Authorizing CMS to permit plans to use notice of electronic posting—and provision of copies upon request—to satisfy disclosure requirements for certain bulky documents to Medicare beneficiaries.
  • Eliminating requirements that plans submit, in addition to their bids, similar and overlapping accounting information.
  • Making it easier for plans to communicate with beneficiaries by streamlining government review and approval of marketing materials used by plans.
  • Improving transparency of the Star Ratings that give beneficiaries information about each Medicare Advantage and Part D plan’s quality rating.

Verma noted that these policies “should serve as tangible examples of our commitment to putting patients first and empowering them with the information they need to make healthcare decisions that are right for them, lowering their drug costs and reducing provider burden to allow them to spend more time on their primary mission—improving their patients’ health and lower drug prices for seniors on Medicare.”

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