CMS plans to crack down on Part D, MA programs

June 4, 2007

Following a series of reports that private insurers involved in the Medicare Advantage (MA) program were using questionable tactics and high-pressured sales efforts, CMS plans to institute reforms and increase supervision of both MA and Medicare Part D plans.

Following a series of reports that private insurers involved in the Medicare Advantage (MA) program were using questionable tactics and high-pressured sales efforts, CMS plans to institute reforms and increase supervision of both MA and Medicare Part D plans. The rule clarifies penalties that may apply to MA and Part D plan sponsors, modify elements of their compliance plans, and give CMS wider access to the records of MA and Part D plan sponsors' first tier, downstream, and related entities. The rule also includes changes to how CMS considers rural health centers and accessibility requirements for home infusion pharmacies. CMS will be accepting comments on the new rule at