The Better Medicare Alliance is recommending a set of policies to Congress and CMS to improve prior authorization, behavioral health access, equity and more in the program.
According to an Oct. 25 news release from the organization, the proposals are designed to modernize the program, which is expected to enroll over 33 million beneficiaries next year.
The Better Medicare Alliance is a pro-MA group backed by major insurers.
Here are 10 policy proposals to know:
- The group is advocating for Congress to allow payers to develop additional supplemental benefits in the program to target social risk factors and subpopulations.
- CMS could improve health equity by standardizing data collection requirements for payers and encouraging partnerships between payers, providers and community organizations around data sharing.
- To enhance supplemental benefits, CMS could provide beneficiaries more information on plans' supplemental offerings on its Plan Finder tool and collect standardized data on use of supplemental benefits.
- The BMA recommended CMS codify regulations for in-home health risk assessments and require plans to incorporate questions around health equity in these assessments.
- CMS could add mental and behavioral health measures to MA plans star ratings to improve outcomes.
- Congress and CMS could require plans to offer mental healthcare at low or no cost and promote the integration of behavioral and primary care, the group recommended.
- To improve provider directory accuracy, Congress could require independent audits of networks from health plans and CMS, with results posted publicly.
- The BMA supports the Seniors Timely Access to Care Act, which would establish electronic prior authorization standards in Medicare Advantage.
- CMS could require health plans to provide beneficiaries with clear and detailed information about prior authorization requirements.
- To reduce misleading marketing CMS could increase oversight of third-party marketing organizations and bar these groups from distributing beneficiaries' contact information, the BMA recommended.
See the full set of policy proposals here.