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Senator, representatives send letter asking CMS to increase oversight.
Problems in Medicare Advantage (MA) are getting worse, not better, despite the best efforts of federal regulators, according to three national lawmakers.
Sen. Ron Wyden (D-Oregon), chair of the Senate Finance Committee, joined with Rep. Richard E. Neal (D-Massachusetts), ranking member of the House Ways and Means Committee, and Rep. Frank Pallone (D-New Jersey), ranking member of the House Energy and Commerce Committee, on a joint letter to the U.S. Centers for Medicare & Medicaid Services (CMS).
Medicare leaders including CMS Administrator Chiquita Brooks-LaSure have enacted rules to improve Medicare Advantage, the legislators said. Those include clarifying when prior authorizations can be used and strengthening market regulations. There is improved coverage for behavioral health services and more culturally competent care, they said.
But constituents are reporting back.
“However, we continue to hear alarming reports from seniors and their families, beneficiary advocates, and health care providers that MA plans are falling short, and finding a good plan is too difficult,” said the letter this week to Brooks-LaSure.
Among the troubles:
“We call on CMS to use every regulatory, oversight, and enforcement tool at the agency’s disposal to rein in rampant misuse of prior authorization, simplify the experience of choosing a Medicare plan, and put an end to rampant marketing abuses,” Wyden, Neal and Pallone’s letter said. They asked for a briefing on audits, oversight and enforcement by Dec. 15.