In this final rule, the Centers for Medicare & Medicaid Services (CMS) implements changes related to Medicare Advantage (MA) inpatient admission decisions, vaccine and insulin cost sharing, the Medicare Prescription Payment Plan, Medicare Advantage dual eligible special needs plans (D-SNPs), Star Ratings, and other programmatic areas. CMS is not finalizing three provisions from the proposed rule:
- Enhancing Health Equity Analyses: Annual Health Equity Analysis of Utilization Management Policies;
- Procedures and Ensuring Equitable Access to Medicare Advantage Services—Guardrails for Artificial Intelligence; and
- Part D Coverage of Anti-Obesity Medications (AOMs) and Application to the Medicaid Program.
There are other provisions from the proposed rule that are not included in this final rule. CMS may address them in future rulemaking, as appropriate. As of January 2023, about 45 percent of rural Medicare beneficiaries were enrolled in an MA plan.