RADAR on Medicare Advantage | CMS Rule Seeks to More Clearly Define Internal Coverage Criteria, AI-Driven Tools

RADAR on Medicare Advantage | CMS Rule Seeks to More Clearly Define Internal Coverage Criteria, AI-Driven Tools

December 5, 2024 issue of RADAR on Medicare Advantage Multiple industry experts say the current administration’s last major Medicare Advantage and Part D rulemaking attempt was largely “business as usual,” with CMS expanding on policies of the Joe Biden presidency and digging further into persistent issues like

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Notification of Supplemental Benefits and Data Integrity: How Will CMS 2025 Final Rule Requirements Affect Your Medicare Advantage Plan?

Notification of Supplemental Benefits and Data Integrity: How Will CMS 2025 Final Rule Requirements Affect Your Medicare Advantage Plan?

Charles Baker, VP, Compliance Solutions and Tammy Hall, Senior Consultant, Compliance Solutions Medicare Advantage (MA) plans offering supplemental benefits have reported enrollee underutilization of many of these benefits. Supplemental benefits may include hearing, dental, vision, fitness programs, over-the-counter drugs, transportation for medical appointments, and other services that address

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