In a recent investigation, the Government Accountability Office (GAO) identified several serious deficiencies in CMS’s oversight and enforcement of network requirements for Medicare Advantage plans, and strongly recommended greater scrutiny of the plans’ networks. The GAO found that CMS reviews less than 1 percent of all networks and does little to assess the accuracy of the network data submitted by the plan. The GAO report found that CMS relies primarily upon complaints from beneficiaries and their caregivers to identify any problems with networks and does not assess whether plans that are renewing their current contracts continue to meet the network requirements.
That’s from a recent Kaiser Family Foundation analysis of Medicare Advantage plan networks. Lots of data and charts in the report at the link.