This is a call to action to comment on CMS-4159-P. The proposed rule revises the Medicare Advantage program (Part C) regulations and prescription drug benefit program (Part D) regulations. As stated in the Executive Summary, one of the goals is to “strengthen our ability to identify strong applicants for Part C and Part D program participation and remove consistently poor performers.” While part of the intent of the revision is to identify inappropriate prescribing of opioid and other potentially harmful medications, these new guidelines may have significant unintended consequences, including limiting access to appropriate symptom management for patients with serious illnesses.