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CMS Releases Guidance on Coverage Criteria, Use of AI and More

On February 6, 2024, the US Centers for Medicare & Medicaid Services (CMS) released a set of frequently asked questions (FAQs) related to Medicare Advantage (MA) coverage criteria and utilization management (UM) requirements....more

CMS Issues Medicare Drug Price Negotiation Initial Guidance, First Inflation Rebate List

On March 15, 2023, the Centers for Medicare and Medicaid Services (CMS) issued initial program guidance related to implementation of the Medicare Drug Price Negotiation Program. CMS requested public comments on selected...more

CMS Updates COVID-19 Guidance for MA Organizations and Part D Sponsors, Addresses the Status of Telehealth Visits for Risk...

Since early March 2020, the Centers for Medicare and Medicaid Services (CMS) has released a steady stream of guidance to Medicare Advantage Organizations (MAOs) and Part D sponsors in connection with the Coronavirus...more

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