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ASAM Submits Comments to CMS Regarding Medicare Advantage Proposed Rule
On February 9th, ASAM submitted comments to the Centers for Medicare and Medicaid Services (CMS) on its proposed rule regarding changes to the Medicare Advantage (MA) program for the 2024 plan year. In the letter, ASAM applauded CMS' proposals to strengthen beneficiaries' access to treatment for opioid use disorder (OUD), including proposals that address MA plans' crippling utilization management (UM) policies. ASAM urged CMS to finalize its proposals that limit the use of prior authorization (PA) to its utility in medical necessity determinations, require MA plans to institute UM review committees, and ensure sufficient training, experience and credentials in addiction care for those involved in the UM review process. ASAM also urged CMS to make additional changes surrounding MA plans' use of PA and recommended CMS finalize, with modifications, its update to MA plan network adequacy requirements to address the needs of substance use disorder (SUD) treatment facilities.