Topic: Medicare Advantage
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Medicare Advantage

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CMS rarely enforces Medicare Advantage networks
FOIA records obtained by KFF Health News show CMS sent enforcement letters to only five insurers after seven Medicare Advantage plans failed provider network adequacy rules from 2016–2022, despite widespread complaints about access. CMS said the findings reflect targeted reviews rather than comprehensive audits, while state assistance program officials reported they were not notified; the revelations come amid rising midyear contract breaks between MA plans and hospital systems during open enrollment.
Medicare Advantage CMS and Health Policy