2022-26956: Medicare Program; Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, Medicare Parts A, B, C, and D Overpayment Provisions of the Affordable Care Act and Programs of All-Inclusive Care for the Elderly; Health Information Technology Standards and Implementation Specifications

Summary

This proposed rule would revise the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE) regulations to implement changes related to Star Ratings, medication therapy management, marketing and communications, health equity, provider directories, coverage criteria, prior authorization, passive enrollment, network adequacy, identification of overpayments, formulary changes, and other programmatic areas. This proposed rule would also codify regulations implementing section 118 of Division CC of the Consolidated Appropriations Act, 2021, section 11404 of the Inflation Reduction Act, and includes a large number of provisions that would codify existing sub-regulatory guidance in the Part C, Part D, and PACE programs. This proposed rule would also amend the existing regulations for Medicare Parts A, B, C, and D regarding the standard for an identified overpayment.

The agency’s own summary, as published.

What this changes

Amends 8 parts of the Code of Federal Regulations — the standing rules this notice rewrites.

• 42 CFR 401 General Administrative Requirements
• 42 CFR 405 Federal Health Insurance for the Aged and Disabled
• 42 CFR 417 Health Maintenance Organizations, Competitive Medical Plans, and Health Care Prepayment Plans
• 42 CFR 422 Medicare Advantage Program
• 42 CFR 423 Voluntary Medicare Prescription Drug Benefit
• 42 CFR 455 Program Integrity: Medicaid
• 42 CFR 460 Programs of All-Inclusive Care for the Elderly (PACE)
• 45 CFR 170 Health Information Technology Standards, Implementation Specifications, and Certification Criteria and Certification Programs for Health Information Technology