Medicare Advantage: Plans generally offered some supplemental benefits, but CMS has limited data on utilization : report to congressional committees

Medicare Advantage: Plans generally offered some supplemental benefits, but CMS has limited data on utilization : report to congressional committees

Collection:
Health Policy and Services Research
Alternate Title(s):
Plans generally offered some supplemental benefits, but CMS has limited data on utilization: report to congressional committees
Contributor(s):
United States. Government Accountability Office, issuing body.
Publication:
Washington, DC : United States Government Accountability Office, January 2023
Language(s):
English
Format:
Text
Subject(s):
Government Regulation
Insurance, Medigap -- legislation & jurisprudence
Legislation, Medical
Medicare Part C -- statistics & numerical data
United States
United States. Department of Health and Human Services
Centers for Medicare & Medicaid Services (U.S.)
Genre(s):
Technical Report
Abstract:
Why GAO did this study. MA plans decide which, if any, supplemental benefits to offer. These benefits may be attractive to Medicare beneficiaries, but little is known about their use. The Bipartisan Budget Act of 2018 includes a provision for GAO to review supplemental benefits. Among other things, this report describes the supplemental benefits offered by MA plans in 2022 and examines the information that CMS has on enrollees’ use of supplemental benefits and their effects on enrollees’ health and function. GAO analyzed plan benefit data for 3,893 MA plans in the 50 states and District of Columbia. GAO excluded certain plans, such as plans participating in the Value-Based Insurance Design Model and employer plans, to ensure comparability between plans. GAO also reviewed CMS regulations and guidance and interviewed officials from CMS and six MA organizations selected based on enrollment, geographic coverage, and other factors. What GAO Recommends. GAO is making two recommendations to CMS: (1) clarify guidance on the extent to which encounter data submissions must include data on the utilization of supplemental benefits and (2) address circumstances where submitting encounter data for supplemental benefits is challenging for MA plans, such as when a given benefit lacks an applicable procedure code. The Department of Health and Human Services concurred with the recommendations.
Copyright:
The National Library of Medicine believes this item to be in the public domain. (More information)
Extent:
1 online resource (1 PDF file (iii, 48 pages))
Illustrations:
Illustrations
NLM Unique ID:
9918589885606676 (See catalog record)
Permanent Link:
http://resource.nlm.nih.gov/9918589885606676