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Life Health > Health Insurance > Medicare Planning

CMS blinks on Medicare proposals

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Medicare program managers have decided to give up on pushing for some especially controversial Medicare Advantage and Medicare Part D prescription drug program proposals.

But officials at the Centers for Medicare & Medicaid Services (CMS) have left open the possibility that they may still complete work on final regulations that would affect Medicare plan agent compensation. 

CMS Administrator Marilyn Tavenner has written about the shift in a letter sent today to members of Congress and also emailed to reporters.

CMS — an arm of the U.S. Department of Health and Human Services (HHS) — has decided to give up trying to implement sections of proposed regulations that would reduce the number of prescription drug plans a carrier could offer in a single market.

CMS also has decided to stop fighting for proposals that would loosen the rules insurers use when developing Medicare drug plan covered drug lists; change the rules governing the plans’ pharmacy networks; and change Medicare drug plan “non-interference” provisions in ways that would require plans to pass any drug discounts on either to CMS or to consumers.

CMS has decided against putting those provisions in final regulations because the issues involved are complex and the agency wants to hear more from stakeholders, Tavenner writes in the letter.

But Tavenner says in the letter that CMS still plans to finalize proposals with bipartisan support.

Those proposals include a provision that would ensure that enrollees have access to care during natural disasters and anti-fraud provisions that would change standards for prescribers of prescription drugs.

The same batch of regulations that included those proposals also included changes in Medicare agent and broker training, testing and compensation rules in a section with the heading “technical changes.”

In the letter to Congress, Tavenner did not talk about CMS plans for the technical changes provisions in the proposed regulations.

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