On January 30, 2024, the Centers for Medicare and Medicaid Services (“CMS”) issued a Request For Information (“RFI”) seeking input from interested parties regarding Medicare Advantage (“MA”) data. CMS’s goals for the RFI are to enhance data capabilities “to have better insight into [MA] programs, consider areas to increase MA data transparency, and propose future rulemaking.” Comments are due on or before May 29, 2024 to be assured consideration.
Comment Request
The RFI encourages feedback from all interested parties on data related to the MA program, and whether or not such data is currently being collected. CMS is particularly interested in comments on the following areas:
- Data-related recommendations regarding beneficiary access to care;
- Network adequacy and provider directory accuracy;
- Prior authorization and utilization management, including denials of care and appeals processes;
- Cost and utilization of different supplemental benefits;
- MA marketing and consumer decision-making;
- Care quality and outcomes, including value-based care and health equity initiatives;
- Healthy competition in the market; and
- Consideration of special populations such as individuals dually eligible for Medicare and Medicaid, individuals with end-stage renal disease and individuals with complex conditions.
CMS is requesting that commenters be as specific as possible and provide details regarding the goals and questions that could be addressed with newly collected or released data regarding the MA program. Moreover, CMS specifically invited health care providers to “provide recommendations related to operational considerations” and to share their “common challenges and experiences in the MA program for which limited data are currently available.”
All interested parties can submit comments until May 29, 2024. Instructions regarding submitting a comment are available here.
If you have any questions or would like assistance in responding to this RFI, please contact one of the following members of Hall Render’s managed care team:
- Amy Mackin at (919) 447-4963 or amackin@hallrender.com;
- Matt Reed at (317) 429-3609 or mreed@hallrender.com; or
- Your primary Hall Render contact.
Special thanks to Alex White, Summer Associate, for his assistance in preparing this alert.
Hall Render blog posts and articles are intended for informational purposes only. For ethical reasons, Hall Render attorneys cannot—outside of an attorney-client relationship—answer specific questions that would be legal advice.
