ASA Urges CMS to Ensure Medicare Advantage Plans Include Sufficient Number of Anesthesiologists in Their Networks

ASA has submitted formal comments to the Centers for Medicare and Medicaid Services (CMS) in response to the agency’s proposed policy and technical changes to the Medicare Advantage and Medicare Part D Benefit Program for CY 2023. In the letter, ASA makes the following points: 

• ASA supports CMS’s proposal to require these plans to demonstrate that they meet network adequacy standards as part of the plan’s application process 
• ASA requests that CMS add anesthesiologists and pain medicine specialists to its list of  specialties for which it specifically tracks network adequacy for these plans 
• ASA recommends that the criteria used by these plans to evaluate the inclusion of a physician or practice group in its network be submitted to CMS and be made publicly available
• ASA emphasizes the need for ongoing monitoring of network adequacy and recommends that CMS require these plans to submit data on an annual basis to ensure appropriate adequacy standards are met and maintained.

ASA specifically notes a disturbing trend of plans not contracting with anesthesiologists – possibly due to implementation of the No Surprises Act – and accentuates the need for robust requirements for ensuring that payer networks include an appropriate number of anesthesiologists.