About APMA

APMA Provides Feedback to CMS on Medicare Advantage Data Collection

  • Jun 3, 2024

On May 29, APMA submitted comments to CMS in response to its request for information (RFI), “Medicare Program; Request for Information on Medicare Advantage Data; CMS–4207–NC.” The RFI gave responders an opportunity to provide feedback on aspects of data related to the Medicare Advantage (MA) program. APMA primarily focused its comments on concerns related to prior authorization and chart review request abuses and the administrative burden it places on clinicians, requesting:

  • CMS require Medicare Advantage Organizations (MAO) plans to provide more detailed and transparent data on the impact of prior authorization as it relates specific provider types and services; and
  • CMS act on the OIG recommendation to perform periodic monitoring to identify MA companies that have a disproportionate share of risk-adjusted payments from chart review.

Members can read this this letter, as well as all other past comment letters, at www.apma.org/CommentLetters. If you have questions or concerns, contact the Health Policy and Practice department at healthpolicy.hpp@apma.org.

Leaderboard Ad image
Leaderboard Ad image