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The Centers for Medicare & Medicaid Services has implemented an online form for providers to submit complaints regarding Medicare Advantage plans.
CMS announced the form in a memorandum issued Dec. 22 that went out to Medicare Advantage Organizations.
As of Monday, Jan. 5, CMS expects all provider complaints to be submitted using the form. It requests information about the complainant, beneficiary, provider, the Medicare Advantage plan and a complaint summary, and provides optional fields for dates of service and the claim number.
The memorandum follows a December memo from CMS announcing the agency’s intent to conduct a voluntary pilot for MA plans. The Service Level Data Collection for Initial Determinations and Appeals pilot begins this year.
CMS said it would collect data related to a Medicare Advantage plan’s initial coverage decision and processed appeal. CMS anticipates expanding the data collection to all MA plans in 2027.
The deadline for interested MA plans to volunteer for the pilot is today, Jan. 9.
Email the writer: SMorse@himss.org