The CMS in a proposed rule is seeking to improve performance of its prescription drug and Medicare Advantage plans by strengthening standards to participate in the Medicare program.
Proposed CMS rule seeks to bolster beneficiary protections
The proposed changes aim to clarify program requirements for more than 4,000 prescription drug and health plan offerings, and improve protections for Medicare beneficiaries enrolled in these plans.
Specifically, the agency is seeking to strengthen its ability to identify and approve qualified drug and health plans; improve Medicare beneficiary protections from discriminatory cost sharing by clarifying health plan requirements relating to out-of-pocket costs and cost-sharing, and eliminate duplication in drug and health plan bids submitted by the same organization.
“CMS is strengthening and simplifying the drug and health plan program in order to deliver a level of service that is more responsive to Medicare beneficiary needs,” Jonathan Blum, acting director of CMS's Center for Health and Drug Plan Choice, said in a written statement. “While CMS made important improvements through the 2010 contracting process, these rules will enable the agency to make further improvements.”
The CMS is also proposing to collect all prescription drug event data elements for non-payment purposes, “to provide more accurate information for analysis of how people with Medicare are using their Part D plan benefits,” according to a statement from the agency. Comments on these proposed revisions are due Dec. 8.
What do you think? Post a comment on this article and share your opinion with other readers. Submit your comments to Modern Healthcare Online at [email protected]. Please be sure to include your hometown and state, along with your organization and title.
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.