America’s Essential Hospitals on Jan. 27 submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the proposed Calendar Year (CY) 2026 Medicare Advantage (MA) and Part D rule. The proposed rule aims to hold MA and Part D plans more accountable for delivering high-quality coverage.
CMS proposed to build on the prior authorization and utilization management protections previously codified in the CY 2024 MA and Part D rule. In comments, the association urged CMS to finalize the provisions and encouraged the agency to establish robust oversight mechanisms to ensure MA organizations comply with the new requirements.
Additionally, in the proposed rule, CMS establishes artificial intelligence (AI) safeguards to uphold the principles of equity and fairness in care delivery. In comments, the associated supported CMS’ efforts to require MA organizations to mitigate bias in AI tools, comply with existing nondiscrimination and cultural competency policies, and ensure equitable access to services regardless of delivery method.
Contact Director of Policy Rob Nelb at rnelb@essentialhospitals.org or 202.585.0127 with questions.
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