August 09, 2016

Mike Adelberg Discusses CMS's New Network Review Policy in Medicare Advantage News

CMS has implemented a new policy where Medicare Advantage plans’ entire provider networks undergo review when requesting service area expansions. As Mike Adelberg, senior director for FaegreBD Consulting, explained in Medicare Advantage News, this creates a peculiar situation for these organizations because of their need to cut legacy counties in pursuit of expansion elsewhere. Adelberg explained it as a need to “service area reduce in order to service area expand.”

“It would be interesting to know how many MA plans have given up counties that they’ve served for many years without complaints about provider access,” Adelberg said.

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