CMS on Thursday (Jan. 25) issued a sweeping request for information soliciting input on which Medicare Advantage data it should be collecting, and where it could improve its current data collection methodologies. The RFI comes as a bipartisan group of lawmakers move to improve the collection of MA supplemental benefit data, a move researchers say would fill a substantial knowledge gap.
“The lack of transparency in Medicare Advantage managed care plans deprives patients of important information that helps them make informed decisions,” said HHS Secretary Xavier Becerra. “It deprives researchers and doctors of critical data to evaluate problems and trends in patient care. Transparency is key to the Biden-Harris Administration’s effort to increase competitiveness and ensure that Medicare dollars are spent on first-rate health care.” In its Thursday RFI, CMS calls for input on a vast array of topics under the MA umbrella. Stakeholders with data-related recommendations related to beneficiary access to care including provider directories and networks should submit comments, as well as those with insights into prior authorization and utilization management denials, beneficiary experiences with appeals and prior authorization algorithms.
CMS is also interested in comments focused on cost and utilization of different supplemental benefits, which has recently been the legislative priority of Sens. Mark Warner (D-VA) and Marsha Blackburn (R-TN).
The agency also solicits information on all aspects of MA marketing and consumer decision-making, plus details on care quality and outcomes including value-based care arrangements and health equity. Additional information on competition, mergers and acquisitions, enrollment concentration and vertical integration are also welcome, the RFI says.
CMS also wants to know more about prescription drug plans, enrollees who are dually eligible for Medicare and Medicaid and enrollees with complex conditions.
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