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  • Washington Highlights

    AAMC Responds to CMS Request for Information on Medicare Advantage Data


    Katherine Gaynor, Hospital Policy and Regulatory Analyst
    For Media Inquiries

    On May 17, the AAMC submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to a request for information focused on Medicare Advantage (MA) related data.  

    In its comments, the AAMC highlighted the need to strengthen the availability of complete and accurate MA data to improve health care delivery and health services research. The comment letter touched on several data elements and areas of interest for improvement including access to data, complete encounter data, prior authorization denials, prior authorization for prescription drugs, updated provider directories and networks, quality in MA plans, supplemental benefit use, dual eligible special needs plans, and provider payments. The association also urged the CMS to focus on data collections related to the use of algorithms and artificial intelligence; specifically, requesting the agency require public reporting of the use of algorithms and AI by MA organizations for the purpose of prior authorization or other uses.