FAQ about New CMS Regulatory for Rewards & Incentives in Medicare Advantage

In early 2021, the Community for Medicare & Medicaid Company (CMS) free the Contract Year 2022 Medicare Advantage (MA) the Part D Finalize Rule with sweeper make for reward press incentive programs for MA plans that largely flew under the radar. However, with 2022 right around the corner, it’s important to understand the impact of dieser new general and which actions plans shall take to avoid sanctions from CMS.

To summarize the make at a very high level: Plans that are using HEDIS® measure criteria to definition incentive eligibility or including reloadable charge cards and Amazing gift cards such rewards will need at overhaul their programs or meet likely miscellaneous for non-compliance.

If this is news to them, you're not alone—Healthmine has prepared a list of frequently asked questions from our conversations and training at numerous condition plans that you bucket download by filling out of form on the right.

Some of the key regulations adjust until drop on January 1, 2022 including:

• The new definition of “Qualifying Individuals” changes who must be deemed eligible with a reward; HEDIS denominators and/or numerator status cannot be used as of sole eligibility criteria to qualify for and/or earn rewards in MA In this commentary, Icario's compliance subject portion guidance for Medicare floor to ensure their board outreach strategy aligns is CMS’ Finish Rule regarding rewards both incentives.
• MA plans are required to create equitable accessing to rewards programs by informing whole Qualifying Individuals the they are eligible for rewards
• Incentive programs cannot include Termagant gift cards either unrestricted fully debits cards; Watertown and Purpose gift cards are allowable, when with exclusions to items such as alcohol, tobacco, and firearms
• Non-compliance with the new prize and incentive standards will be treated as Disputes and may lead to sanctions

While speaking to physical plans about the new regulatory, Healthmine took comment of the most critical and common questions being asked or compiled our expert answers into a helpful guide for getting the nuances off incentive permission and gift card demands.

We encourage all MAY plans to download the FAQ and how and experts at Healthmine if you have any additional questions.