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Written clinical review criteria must be developed with the involvement of health plan practitioners. They must be made available to plan practitioners and enrollees.
All private health care plans should be held accountable for their actions.
Enrollees in private health plans should have appropriate access to, information about, and protections within clinical trials.
Hospice care is ordinarily covered through the Traditional Medicare Part A program.
Private health plans must prevent the improper use or release of personally identifiable medical information.
All health plans serving Medicare beneficiaries must collect and report comparable, independently audited data to demonstrate compliance with national standards.
CMS should monitor the activities of all private health plans participating in Medicare to ensure compliance with all requirements.