The Task Force Provides Input to CMS on Medicare Advantage Data Request for Information

The Health Care Transformation Task Force submitted input to the Centers for Medicare & Medicaid Services (CMS) in response to a Request for Information on Medicare Advantage (MA) data collection. The Task Force recommends that new MA data collection and reporting requirements should:

  1. Center on Consistent Definitions in Any New MA Data Collection Efforts: Any new MA plan data collection requirements should center on consistent definitions, including for value-based payment, value-based care, and health equity.
  1. Be Reasonable to Achieve a Stated Purpose Not Currently Being Met: Any new MA plan data collection and reporting requirements should be for a stated purpose that is not served by current data collection and reporting requirements.
  1. Focus on Improved Comparisons to Traditional Medicare: Any new MA plan data collection and reporting requirements should be aligned with CMS alternate payment models requirements, particular for purposes of quality measures.
  1. Include Public Disclosure Safeguards: CMS should ensure that any new data collected from MA plans and made publicly available is reported an appropriate level of aggregation to protect proprietary or other commercially sensitive information as well as enrollee data to protect against improper use by third parties.
  1. Be Promulgated Through Rulemaking to Ensure Necessary Public Input: New MA data collection and reporting requirements should be established through notice and comment rulemaking to ensure adequate public input.
  1. Inform National Standards for Denial Codes: CMS should consider using new data reporting requirements to collect information from MA plans on how they use denial codes for prior authorization and medical coverage determinations to inform a future set of uniform denial codes.


Read the Letter Here