CMS has implemented significant regulatory changes to network adequacy standards that require Medicare Advantage (MA) plans to quickly adapt to ensure compliance. Read on for an overview of the necessary steps plans must take to meet these new requirements. Convert Letters of Intent. Health plans that submitted
Read More →RADAR on Medicare Advantage | Risk Scores, Star Ratings Are Catalysts to Watch in Medicare Advantage
Reprinted with AIS Health permission from the 1/4/24 issue of Radar on Medicare Advantage 2024 Medicare Advantage Outlook For our annual series of outlook stories on the year ahead in Medicare Advantage, AIS Health, a division of MMIT, spoke with more than a dozen industry experts on the
Read More →– by Jocelyn Bayliss, Program Lead, Provider Network Management & Tina Gallagher, Market Manager, Provider Network Management In April 2023, CMS issued a final rule that added two new specialty types, clinical psychology and clinical social work, to network adequacy standards. Addition of Specialty Types and Amendments
Read More →CMS requires applicants to demonstrate they have a sufficient network of contracted providers before an initial or service-area expansion application is approved. In addition, for CY 2024, CMS will adopt regulations explicitly permitting it to deny applications based on an applicant’s failure to meet network adequacy criteria. Plans
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