New Network Adequacy Requirements

CMS CY2025 Medicare Advantage Final Rule

Your Guide to Understanding Network Adequacy Requirements for Medicare Advantage Organizations

The CMS Contract Year 2025 Medicare Advantage and Part D Final Rule introduces changes in network adequacy criteria that will impact how Medicare Advantage organizations operate. Our policy brief breaks down these essential requirements, providing you with a clear understanding of what is expected under the new regulations. Key points include:

  • Addition of Outpatient Behavioral Health Facility-Specialty Type
  • Two Network Adequacy Exceptions for I-SNPs: 
  • Emphasis on Provider Directory Accuracy

 

Download our policy brief today to leverage expert analysis and guidance on complying with the new network adequacy criteria.

CY2025 Medicare Advantage Policy Brief New Network Adequacy Requirements. Download now.

Find More Medicare Advantage Resources

Reduce Your Regulatory Risk - CMS Medicare Advantage Network Adequacy Audit Checklist from Quest Analytics

Looking for more tips to help you stay review-ready and compliant-confident with CMS? We’ve got them! Explore our CMS Resource Hub to find our growing collection of guides, videos and tools to help you achieve your compliance and service area expansion goals.

Proven Solutions for Your Provider Network Management

Looking to simplify your workload? Let Quest Analytics take on the heavy lifting! Our solutions and dedicated team specialize in provider data accuracy and provider network adequacy for various lines of businesses, including Medicare Advantage, Medicaid and Commercial. Schedule a strategy session today and see how we can help you every step of the way!

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