Academy Provides Recommendations for Increasing Transparency in Medicare Advantage Hearing Benefits

On February 20, the Centers for Medicare and Medicaid (CMS) issued a request for information (RFI) on increasing transparency around certain aspects of Medicare Advantage (MA). This RFI specifically sought information from stakeholders about care access, provider networks, prior authorization, supplemental benefits, value-based care arrangements, health equity, marketing, and care quality. In addition, the RFI seeks feedback on healthy competition in the MA market, the effects of vertical integration, and how to improve data collection and release methods.

The Academy comments provided that increased transparency around the nature and amount of the hearing benefit, and the professional services included, is needed to provide consumers with the requisite information necessary to make an informed decision.

In addition, provider network listings should be readily available and consumers should have the ability to choose their provider. Third-party administrator (TPA) contracts should not constrain the professional judgement of the audiologist/provider in discussing appropriate clinical treatment options, nor should they include provisions that unfairly bind the audiologist to participation in other contracts/networks. Finally, there should be greater connectivity between the insurer/plan and the TPA that is charged with administering the benefit.