Bloomberg Law
Dec. 14, 2022, 9:21 PMUpdated: Dec. 14, 2022, 11:39 PM

Biden HHS Moves to Adjust Private Medicare Plans, Drug Coverage (1)

Tony Pugh
Tony Pugh

The Biden administration on Wednesday issued a proposal to tweak Medicare managed care plans and the Medicare prescription drug benefit in 2024.

The proposed rule (RIN 0938-AU96) from the Centers for Medicare & Medicaid Services would require prior authorization approvals by private Medicare Advantage plans to remain valid for the beneficiary’s full course of treatment. It also would require plans to review their utilization management policies each year and require MA plan coverage determinations to be reviewed by professionals with “relevant expertise,” the CMS said in a statement.

The policy proposals complement those in the CMS’ recent ...