PACE, MAP, and Medicare Advantage

PACE, MAP, and Medicare Advantage CMS Draft 2026 MA/PACE Rule Addresses Prior Authorization and Supplemental Benefit Cards: The draft proposed rule includes new guardrails for prior authorization and utilization management and clarifies the administration and use of debit cards as supplemental benefits.
December 3, 2024

PACE, MAP, and Medicare Advantage Proposed PACE Regulations Published for Comment: Comments are due Oct. 6th.
August 13, 2024

PACE, MAP, and Medicare Advantage Draft PACE Regulations Presented to Public Health and Health Planning Council: The draft regulations contain a unified licensure process for PACE programs. Existing programs would be subject to specified requirements.
July 9, 2024

PACE, MAP, and Medicare Advantage Deadlines for Medicare Advantage Plan Applications Announced: DOH has released deadlines for the submission of applications to the State to establish new Medicare Advantage plans and expand Medicare Advantage plan service areas for Medicare Coverage Year 2026.
June 25, 2024

PACE, MAP, and Medicare Advantage PACE Organizations: Register for CMS Call on Risk Adjustment Submission Changes by June 7th: Updates for PACE include reminder of upcoming Medicare recoupment, clarification on changes to FI administrative cost reimbursement.
June 4, 2024

PACE, MAP, and Medicare Advantage CMS Webinar on New Interoperability and Prior Authorization Rule: Slides and Recording Now Available: CMS hosted a webinar on the new Interoperability and Prior Authorization Final Rule. The new Rule is intended to improve health information exchange to facilitate access to health records for patients, health care providers, and payers and streamline prior authorization processes implemented by government-funded payers.
April 2, 2024

PACE, MAP, and Medicare Advantage CMS to Host Webinar on New Interoperability Rule: The March 26^th webinar will provide information to providers, patients, and plans about the new data sharing and prior authorization rule.
March 5, 2024

PACE, MAP, and Medicare Advantage CMS Updates Data Submission System for Medicare Advantage and PACE Supplemental Benefits: CMS updated instructions and systems to facilitate the submission of data on supplemental benefits in the Medicare Advantage Encounter Data System on Feb. 21^st.
February 27, 2024

PACE, MAP, and Medicare Advantage CMS Proposal Projects 3.7 Percent Payment Increase for Medicare Advantage: The Advance Notice makes methodology changes and proposes CY 2025 payment levels for Medicare Advantage plans.
February 15, 2024

PACE, MAP, and Medicare Advantage DOH, Deloitte Review Update to PACE Rates: The update incorporates the impact of minimum wage increases and other State policy changes into April 2023 rates.
January 30, 2024