2017-25068: Medicare Program; Contract Year 2019 Policy and Technical Changes to the Medicare Advantage, Medicare Cost Plan, Medicare Fee-for-Service, the Medicare Prescription Drug Benefit Programs, and the PACE Program

Summary

This proposed rule would revise the Medicare Advantage program (Part C) regulations and Prescription Drug Benefit program (Part D) regulations to implement certain provisions of the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act; improve program quality, accessibility, and affordability; improve the CMS customer experience; address program integrity policies related to payments based on prescriber, provider and supplier status in Medicare Advantage, Medicare cost plan, Medicare Part D and the PACE programs; provide a proposed update to the official Medicare Part D electronic prescribing standards; and clarify program requirements and certain technical changes regarding treatment of Medicare Part A and Part B appeal rights related to premiums adjustments.

The agency’s own summary, as published.

What this changes

Amends 5 parts of the Code of Federal Regulations — the standing rules this notice rewrites.

• 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 498 Appeals Procedures for Determinations That Affect Participation in the Medicare Program and for Determinations That Affect the Participation of ICFs/IID and Certain NFs in the Medicaid Program