CMS seeks comments on inappropriate steering to individual market plans

The Centers for Medicare & Medicaid Services yesterday issued a request for information as it develops regulatory or operational changes to address concerns, based on anecdotal reports, that some health care providers or provider-affiliated organizations may be steering people eligible for or receiving Medicare and/or Medicaid benefits to individual market health plans to obtain higher payment rates. CMS also informed all Medicare-enrolled dialysis facilities about the announcement, saying the actions are part of ongoing efforts by the CMS Center for Program Integrity to address possible issues in the Health Insurance Marketplace. Among other comments, CMS seeks information on the types of situations in which steering may occur and potential policies to address it, such as changes to civil monetary penalty regulations related to individual market plans or Medicare and Medicaid provider enrollment requirements and conditions of participation. The RFI will be published in the Aug. 23 Federal Register with comments accepted for 30 days.