The Centers for Medicare and Medicaid Services wants public input to guide possible future regulations to mandate greater transparency from Medicare Advantage plans, according to a request for information issued Thursday.
The agency has sought to shed more light on Medicare Advantage operations and finances in recent years and required insurers to reveal information in areas such as medical loss ratio calculations, prior authorization processes, supplemental benefits and health equity.
Related: CMS proposes stricter Medicare Advantage marketing rules
“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," Health and Human Services Secretary Xavier Becerra said in a news release. "Transparency is key to the Biden-Harris administration’s effort to increase competitiveness and ensure that Medicare dollars are spent on first-rate healthcare.”
The request for information touches on a number of areas in which CMS may consider new policymaking, including:
- Provider directories and networks
- Prior authorization and utilization management
- Coverage denials and appeals
- Use of algorithms
- Costs and utilization of supplemental benefits
- Marketing and consumer decision-making
- Quality and outcomes
- Health equity
Responses will be due 120 days after the request for information formally appears in the Federal Register, which is scheduled to occur Tuesday.
