On January 25th, the Biden-Harris Administration launched efforts to increase Medicare Advantage transparency in order to increase competition. The Centers for Medicare and Medicaid Services (CMS) has already begun collecting more data related to various aspects of MA, including more comprehensive payment data related to Medical Loss Ratios (MLRs), new data streams for supplemental benefits costs and utilization, new data collection and public posting requirements related to prior authorization, and new collection of race and ethnicity data. CMS has also increased requirements for the completeness of encounter data.
This newly released request for information (RFI) seeks input from the public regarding various aspects of Medicare Advantage (MA) data including access to care, prior authorization, provider directories, and networks; supplemental benefits; marketing; care quality and outcomes; value-based care arrangements and equity; and healthy competition in the market, including the effects of vertical integration and how that affects payment. CMS is also seeking comments on improving MA data collection and release methods. The RFI has an extended comment period of 120 days to encourage feedback from a wider array of stakeholders and to allow time for convenings and other efforts to synthesize detailed feedback to CMS. Comments are due on May 29, 2024, and LeadingAge will be engaging members through various networks to gain insights and feedback for their comments.
