On January 25, the Centers for Medicare & Medicaid Services (CMS) announced a data request for information (RFI) to solicit feedback from the public on how best to enhance Medicare Advantage (MA) data capabilities and increase public transparency. CMS encourages feedback from a wide array of interested parties, including beneficiaries and beneficiary advocates, plans, providers, community-based organizations, researchers, employers and unions, and all other interested parties, including the public at large.
CMS requests comments on all aspects of data related to the MA program, including:
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Data-related recommendations related to beneficiary access to care including provider directories and networks.
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Prior authorization and utilization management, including denials of care and beneficiary experience with appeals processes as well as use and reliance on algorithms.
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The cost and utilization of different supplemental benefits.
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All aspects of MA marketing and consumer decision-making.
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Care quality and outcomes, including value-based care arrangements and health equity.
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Healthy competition in the market, including the impact of mergers and acquisitions, high levels of enrollment concentration, and the effects of vertical integration, data topics related to Medicare Advantage prescription drug plans (MAPDs).
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Special populations such as individuals dually eligible for Medicare and Medicaid, individuals with end-stage renal disease (ESRD), and other enrollees with complex conditions.
Comments must be received by Wednesday, May 29, 2024.
Click here to access the RFI.