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CMS releases final rule for 2026 Medicare Advantage, prescription drug plans – RamaOnHealthcare

Summary by ramaonhealthcare.com
The Centers for Medicare & Medicaid Services April 4 finalized changes to the Medicare Advantage and prescription drug programs for contract year 2026. The rule finalizes proposed clarifications requiring MA and Part D plans to honor medical necessity decisions rendered as part of a prior authorization process, closes loopholes in MA appeals processes by explicitly [...]
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ramaonhealthcare.comramaonhealthcare.com

CMS releases final rule for 2026 Medicare Advantage, prescription drug plans – RamaOnHealthcare

The Centers for Medicare & Medicaid Services April 4 finalized changes to the Medicare Advantage and prescription drug programs for contract year 2026. The rule finalizes proposed clarifications requiring MA and Part D plans to honor medical necessity decisions rendered as part of a prior authorization process, closes loopholes in MA appeals processes by explicitly [...]

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American Hospital AssociationAmerican Hospital Association

CMS releases final rule for 2026 Medicare Advantage, prescription drug plans

The Centers for Medicare & Medicaid Services April 4 finalized changes to the Medicare Advantage and prescription drug programs for contract year 2026. The rule finalizes proposed clarifications requiring MA and Part D plans to honor medical necessity decisions rendered as part of a prior authorization process, closes loopholes in MA appeals processes by explicitly defining organizational determinations eligible for appeal, and codifies requirem…

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American Hospital Association broke the news in on Friday, April 4, 2025.
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