Medicare Advantage: 2023 Final Rule Focuses on Social Determinants of Health and Utilization Review
This Featured Article is contributed by AHLA's Regulation, Accreditation, and Payment Practice Group.
- April 14, 2023
- Judith A. Waltz , Foley & Lardner LLP
- Alexandra B. Shalom , Foley & Lardner LLP
Finalizing most of the provisions of a proposed rule (Proposed Rule) issued in December 2022,[1] the Centers for Medicare & Medicaid Services (CMS) issued a massive rule (Final Rule)[2] amending regulations for Medicare Advantage (MA or Part C), Medicare Cost Plan, the Medicare Prescription Drug Benefit (Part D) programs, and Programs of All-Inclusive Care for the Elderly (PACE). The changes may have significant impact on MA Organizations (MAOs), providers and suppliers of services to MAOs, and Medicare managed care beneficiaries.
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