ASNC Comments to CMS on Medicare Advantage Plans

ASNC-Comments-to-CMS-on-Medicare-Advantage-Proposed-Rule_01-27-2025

ASNC asked the Centers for Medicare & Medicaid Services to finalize several proposals that would make it harder for Medicare Advantage (MA) plans to use certain internal coverage criteria or policies and guidelines when making coverage decisions. In this letter, ASNC also discussed the policies of some insurance companies that automatically deny coverage of cardiac PET and other appropriate functional stress tests for the evaluation of stable chest pain and require CCTA as a first-line test. ASNC also voiced support for greater disclosure of prior authorization use by MA organizations, including requiring that the percentage of prior authorization denials and approvals must be reported at the item and service level, rather than in aggregate.