Publication

New Changes Proposed for the Medicare Advantage and Prescription Drug Benefit Programs (CMS-4159-P)

Richard P. Kusserow | March 2014

The Part D Medicare prescription drugย benefit was enacted as part of the Medicareย Modernization Act of 2003 and providesย extensive drug coverage for seniors and theย disabled, allowing them to get prescriptionsย as quickly as possible. In the timeย since Part D was enacted, some have arguedย that Medicareโ€™s focus on speedy deliveryย has its downsides. On January 6, 2014, theย Centers for Medicare & Medicaid Servicesย (CMS) issued a proposed rule designed toย strengthen protections, improve health careย quality, and reduce costs for Medicare beneficiaries with private Medicare Advantageย (MA) and Part D prescription drug plans inย contract year 2015. (1) ย It is intended to bringย extensive reforms to theย Medicare Advantageย (โ€œPart Cโ€) and Medicare Prescription Drugย Benefit Program (โ€œPart Dโ€), partly throughย regulations implementing provisions of theย Affordable Care Act (ACA).


1. Proposed rule was published in the Federal Register on January 10, 2014. CMS will accept comments on the proposed rule until March 7, 2014.

About the Author

Richard P. Kusserow established Strategic Management Services, LLC, after retiring from being the DHHS Inspector General, and has assisted over 3,000 health care organizations and entities in developing, implementing and assessing compliance programs.