The American Hospital Association (AHA) and the Alliance of Community Health Plans (ACHP) are asking the Centers for Medicare and Medicaid Services (CMS) to finalize its 2025 Medicare Advantage and Part D proposed rule that would provide a number of reforms for the MA program.
In a lengthy letter highlighting several key points of the...National News
Last week, the Senate Finance Committee held a hearing on the topic of "cracking down on deceptive practices" related to the advertisement of Medicare Advantage (MA) plans.
The hearing covered a long list of issues with third-party marketers who represent MA plans, including allegations of false information, harassment, switching...CMS Rules
Last week, the Centers for Medicare and Medicaid Services released a final rule taking aim at prior authorization and its use in Medicare Advantage. The rule also makes changes to the star ratings program and marketing reforms.
The rule stipulates that once a health plan grants prior authorization for a service, the approval will...
Lawmakers and stakeholders are still very upset with the U.S. Department of Health and Human Services' (HHS) plan to cut payments to the Medicare Advantage (MA) program and to enforce regulations against MA plans that have benefitted financially from improper overpayments. This week, HHS Secretary Xavier Becerra defended the rule in two...
Medicare Advantage officially has 30 million enrollees. But with great patient volume comes great responsibility according to the Centers for Medicare and Medicaid Services (CMS), which has pledged tougher audits while finalizing tougher rules for MA plans.
The announcement that MA had crossed the 30 million enrollees mark was made...
Last week, the Centers for Medicare and Medicaid Services (CMS) released a Request for Information (RFI), seeking comment on ways to improve Medicare Advantage and make the program more equitable, affordable and sustainable.
Medicare Advantage (MA) has been under great scrutiny lately, for policies on prior authorization, the adequacy...
This week in Medicare Advantage news, the home-based care industry is gearing up to assert itself amid concerns that home care services are being inadequately compensated. A new bill modeled on existing Texas law tries to limit the harms caused by prior authorization in Medicare Advantage plans. Also, Centene is concerned about its star...Top of The Day
The extent to which Medicare Advantage (MA) plans may be overcompensated is unclear, and the ways in which insurers make money off of MA are more complicated than simple reimbursement from the Medicare program. A new report from the USC-Brookings Schaeffer Initiative for Health Policy demonstrates that parent companies that offer MA...
