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CMS Proposes Changes and Updates to Medicare Advantage

The Centers for Medicare and Medicaid Services (CMS) published a proposed rule in the Nov. 28th Federal Register that would make numerous changes to the Medicare Advantage program, including altering requirements on how some plans, including Programs of All-Inclusive Care for the Elderly (PACE), would need to identify eligible providers and prescribers. CMS proposes to substitute the current provider and prescriber enrollment requirement with a “preclusion list” of prescribers and providers to whom plans would be prohibited from making claim payments.

CMS is accepting comments until Jan. 16, 2018. A fact sheet is available here, and the text of the 700-page rule is available here.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841