Dive Brief:
- CMS is calling for new rules for the Medicare Advantage program that require insurers to give members and providers more notice of major network changes and terminations.
- Under the proposed rules, which also include a 2015 reduction in payment to Medicare Advantage plans, the plans would have to give beneficiaries more than 30 days' advance notice of network changes, providers at least 60 days' advance notice of contract terminations, and Medicare officials at least 90 days' notice of planned terminations.
- Insurance industry trade group America's Health Insurance Plans opposes these new Medicare Advantage rules, which it said would hurt insurers' contract negotiations with providers and weaken their ability to enforce termination provisions in provider contracts.
Dive Insight:
Anecdotally, insurers taking part in Medicare Advantage plans are doing very well indeed. They appear to be extremely profitable and offer a fast-growing market as baby boomers continue to age. If giving notice of terminations to stakeholders inconveniences the health plans, that's unfortunate, but probably necessary, so all the players involved know what's happening in time to take appropriate steps.