tci Medicare Compliance & Reimbursement - 2024 Issue Q2

Medicare Advantage: New Rule Circumvents Beneficiary Data Sharing

Feds also aim to rein in brokers’ avarice. With rising concerns that third-party brokers are pushing beneficiaries into Medicare Advantage while pocketing higher compensation, CMS aims to curb predatory practices with stricter parameters and beneficiary protections in the new rule. Context: Last month, the Centers for Medicare & Medicaid Services (CMS) issued a final rule in the Federal Register that impacts the remainder of the 2024 Contract Year (CY) and the 2025 CY. The rule finalizes equity proposals and strengthens access, healthcare options, and protections for patients in Medicare Advantage (MA) plans. A primary policy change includes a revised...

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