"2025 Medicare Advantage and Part D Final Rule: New CMS Guidance and Protections for Beneficiaries"
The Centers for Medicare & Medicaid Services (CMS) issued a final rule for the Contract Year 2025 Medicare Advantage and Part D programs, introducing changes to enhance protections, promote healthy competition, and ensure plans meet enrollees' needs. The rule includes provisions to prevent anti-competitive steering by agents and brokers, limit the distribution of personal beneficiary data, improve access to behavioral health care providers, increase awareness of unused supplemental benefits, and establish new standards for special supplemental benefits for the chronically ill. Additionally, the rule aims to analyze utilization management policies from a health equity perspective, enhance enrollees' rights to appeal plan decisions, and increase the percentage of dually eligible enrollees receiving Medicare and Medicaid services from the same organization.
- Contract Year 2025 Medicare Advantage and Part D Final Rule (CMS-4205-F) CMS
- Biden-Harris Administration Finalizes Rule Expanding Access to Care and Increasing Protections for People with Medicare Advantage and Medicare Part D HHS.gov
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