HHS & CMS are looking for comments related to all aspects of the MA program including access to care, PA, care quality and more

WASHINGTON—The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), released a Request for Information (RFI) to solicit feedback from the public on how best to enhance Medicare Advantage (MA) data capabilities and increase public transparency. 

“Transparency is especially important now that MA has grown to over 50% of Medicare enrollment, and the government is expected to pay MA health insurance companies over $7 trillion over the next decade,” CMS said.
The information solicited by this RFI will support efforts for MA plans to best meet the needs of people with Medicare, for people with Medicare to have timely access to care, to ensure that MA plans appropriately use taxpayer funds, and for the market to have healthy competition. 

CMS is seeking data-related input from the public related to all aspects of the MA program, 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. 

It 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.

“Americans with Medicare who have managed care plans called Medicare Advantage should not feel like their health care is a black box,” said HHS Secretary Xavier Becerra. “The lack of transparency in Medicare Advantage managed care plans deprives patients of important information that helps them make informed decisions. 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.”

“The Biden-Harris Administration is committed to improving the Medicare Advantage program,” said CMS Administrator Chiquita Brooks-LaSure. “This Request for Information builds on our existing Medicare Advantage data transparency efforts to further align with Traditional Medicare and provide the data we need to ensure the growing Medicare Advantage program best meets the needs of enrollees.” 

“In health care, you can’t improve what you don't know, and the way to know is with data. We need to have transparent Medicare Advantage data to see what’s working and what’s not working to inform our efforts to protect enrollees and drive high-quality care and competition,” said Meena Seshamani, MD, PhD, CMS deputy administrator and director of the Center for Medicare. “Through this RFI, we look forward to engaging all parties interested in the Medicare Advantage program.”

The MA Data RFI can be accessed on the Federal Register’s webpage at federalregister.gov/public-inspection/2024-01832/request-for-information-medicare-advantage-data. Comments are due on May 29, 2024.