CMS issued an update to their network adequacy guidance on March 4, 2022. This document is developed by CMS and offers details regarding MA network adequacy requirements, specialty types, quantitative measurements of network adequacy, compliance and enforcement efforts, instructions to upload HSD table, and exception requests instructions.
CMS issued its proposed rule for Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs.
CMS is “proposing to require an applicant to demonstrate compliance with network adequacy standards as part of the MA application process for new and expanding service areas and to adopt a time-limited 10 percentage point credit toward meeting the applicable network adequacy standards for the application evaluation”. This will start with CY 2024.
