May 28, 2015

Mike Adelberg Tells Medicare Advantage News How New Tech Will Boost CMS

As detailed in the latest edition of Medicare Advantage News, the relationship between the Centers for Medicare and Medicaid Services (CMS) and Medicare Advantage (MA) providers will soon be much more technologically streamlined. At the end of July, the CMS will unveil a "more robust version" of its Network Management Module (NMM). The new software will give CMS a broader, more efficient and more standardized means of evaluating whether MA insurers meet CMS standards for beneficiary access to care providers. Mike Adelberg, senior director for FaegreBD Consulting, weighed in on how the new NMM—expected to be formally introduced in 2016—will affect MA insurers.

"The tool will let CMS measure provider networks 365 days a year," Adelberg said. "MA plans will have to stay focused on keeping their networks as strong as they were when first approved."

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