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CMS Issues Final Rule on Changes to the Medicare Advantage and Part D Programs


On April 6, 2010, CMS issued a final rule that revises regulations governing the Medicare Advantage program and the Part D prescription drug benefit program. The proposed rule was issued on October 22, 2009. Click here for our summary on

According to CMS, the final rule strengthens beneficiary protections, ensures that plan offerings to beneficiaries include meaningful differences, improves plan payment rules and processes, strengthens various program participation and exit requirements, improve data collection for oversight and quality assessment, implement a new Part D formulary policy, and clarify or add other important program requirements. The final rule also includes a dispute and appeals process for risk-adjustment data validation.

The final rule will be published in the Federal Register on April 15, 2010, but is available now at

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