The Washington Report

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April 10, 2019

Health

CMS Releases Contract Year 2020 Medicare Advantage and Part D Flexibility Final Rule; Includes Telehealth Access
On April 5, 2019, the Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) released a final rule that will “strengthen popular Medicare private health insurance plans, expand telehealth access for patients, and improve coordination for dual-eligible individuals.” The final rule will revise the Medicare Advantage program (Part C) regulations and Prescription Drug Benefit program (Part D) regulations to implement certain provisions of the Bipartisan Budget Act of 2018; improve quality and accessibility; clarify certain program integrity policies for Medicare Advantage, Part D, and cost plans and Programs of All-Inclusive Care for the Elderly (PACE) organizations; reduce burden on providers, Medicare Advantage Plan plans, and Part D sponsors through providing additional policy clarification; and implement other technical changes regarding quality improvement. The final rule will also revise the appeals and grievances requirements for certain Medicaid managed care and Medicare Advantage special needs plans for dual-eligible individuals to implement certain provisions of the Bipartisan Budget Act of 2018. The rule is effective January 1, 2020, except for provisions as noted in the final rule. Please refer to the rule for details.

The final rule is temporarily available here.
(The final rule will be published in the April 16, 2019, Federal Register.)

The news release is available here.

The final rule is temporarily available here.