CMS Issues RFI Requesting Thoughts on Medicare Advantage

Regulation | August 03, 2022 | by Nicole Fallon

The Center for Medicare and Medicaid Services (CMS) issued a request for information (RFI) on various aspects of the Medicare Advantage(MA)  program in the Federal Register on Monday, August 1. LeadingAge will be submitting comments by the August 31 deadline and members are encouraged to share their experience, too. This is a rare opportunity to let CMS know how you think the MA program can be improved.

CMS seeks feedback from a wide variety of stakeholders on ways MA can:

  • Advance Health Equity;
  • Expand Access to Coverage and Care;
  • Drive Innovation to Promote Person-Centered Care;
  • Support Affordability and Sustainability; and
  • Engage Partners

CMS poses numerous questions within each of the categories in the RFI. We’ve reviewed the RFI and have collapsed the CMS questions into the following areas. We are seeking feedback from members around the country about their recent experiences with Medicare Advantage and how things have changed over time in the areas of:

  • Contracting
  • Payments in relationship to Medicare fee-for-service payment and any value-based arrangements/payment agreements you may have with an MA plan
  • Provider network requirements and when excluded
  • Prior authorizations and other utilization management approaches used by MA plans
  • Access to care issues you’ve observed
  • Your estimated administrative burden from working with MA plans and 
  • Any data you think CMS should collect about MA and Special Needs plans that may be useful for providers or beneficiaries. 

We’ve put together a list of more detailed questions on each of these topics to help inform our comments to CMS by hearing from you. All information provided by members will be aggregated when including it in the LeadingAge comments on the RFI. Members’ comments will not be individually identified. All information submitted by members will be used for this RFI and other advocacy efforts in both the Administration and Congress.

Please email any feedback on the linked questions to Nicole Fallon by August 22 so they can be aggregated and included in the LeadingAge comments to CMS on the RFI and at an upcoming meeting with CMS Deputy Administrator and Director of Medicare, Meena Seshamani. Members can submit comments  directly to CMS on the RFI at: http://www.regulations.gov but they are due no later than August 31.