Which agency regulates Medicare Advantage and Prescription Drug Plans?

The Centers for Medicare & Medicaid Services (CMS) is the agency responsible for regulating Medicare Advantage and Prescription Drug Plans. CMS establishes the standards and guidelines that these plans must adhere to, ensuring that they meet the necessary requirements to provide adequate care and coverage for beneficiaries. This oversight includes monitoring the services provided, managing plan ratings, and ensuring compliance with federal laws to protect consumers.

CMS plays a crucial role in the Medicare program as it administers various aspects of both Medicare Parts A and B, along with Part C (Medicare Advantage) and Part D (prescription drug coverage). By regulating these plans, CMS ensures that they operate within the framework of federal regulations, providing beneficiaries with access to appropriate healthcare options while maintaining quality and affordability.

Other agencies, such as the Department of Health and the State Health Department, may have roles in public health or state-specific health regulations, but they do not have the regulatory authority over Medicare Advantage and Prescription Drug Plans as CMS does. The National Medicare Society is not a recognized federal agency and does not have any regulatory power over Medicare programs.