MA Prior Auth, Marketing, Provider Directories Targeted In CMS Proposal

By Jalen Brown / November 26, 2024 at 7:34 PM
Medicare Advantage plans should be required to share their entire provider directory with CMS, the agency said Tuesday (Nov. 26) in its proposed 2026 MA and Part D rule, where the administration also proposed bolstering prior authorization reporting and expanding the definition of what counts as MA plan marketing that CMS can regulate. The proposed rule would also ensure, beginning Jan. 1, 2026, MA plans cannot charge higher in-network cost-sharing for behavioral health services -- like mental health specialty care,...


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