CMS Issues Final Rule for 2025 Medicare Advantage and Part D Prescription Drug Program

The changes from the Centers for Medicare & Medicaid Services (CMS) are intended to improve access to behavioral health care; cap and standardize MA plan compensation to brokers which includes prohibiting volume-based bonuses for enrollment into certain plans; streamline enrollment for individuals dually eligible for Medicare and Medicaid; and annually review MA utilization management policies for health equity considerations. Medicare Advantage enrollments continue to become a significant form of insurance coverage for Medicare eligible rural enrollees with 45.1 percent of nonmetropolitan eligible beneficiaries are enrolled in a MA plan (November 2023 RURPI Rural Policy Brief). Additionally, MA enrollment grew by 7.7 percent (2.2 million) from 2022 to 2023; the highest rate of growth was observed in non-metropolitan counties.

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