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Proposed rule strengthens equity and behavioral health in Medicare Advantage program

Proposed rule strengthens equity and behavioral health in Medicare Advantage program

December 16, 2022Susan MorseHealthcare FinanceSocial Determinants of Health (SDOH),Behavioral Health Services,Medicare ACOs/MSSP

For the first time, the Center for Medicare and Medicaid Services is proposing to establish a health equity index in the Medicare Advantage and Part D Star Ratings program that would reward excellent care for underserved populations. The proposed rule would also update the Medicare Part D medication therapy management program to require that plans include all 10 core chronic diseases identified by CMS – including HIV/AIDS – in their medication therapy management targeting criteria.

Plans would also be required to provide culturally competent care to an expanded list of populations and to improve equitable access to care for those with limited English proficiency, through newly proposed interpreter standards and the requirement that materials be provided in alternate formats and languages, CMS said.

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