The Centers for Medicare and Medicaid Services (CMS) have taken the next step on the Medicare Prescription Payment Plan draft guidance, which is required by the Inflation Reduction Act of 2022 to advance President Joe Biden's plan to lower drug costs for seniors.
The draft guidance provides communication and education requirements for...National News
A new white paper by Harvard Medical School and Inovalon, a company that provides health data aggregation services, compared healthcare utilization and expenditures between Medicare Fee-for-Service (FFS) and Medicare Advantage beneficiaries.
The paper, "Utilization and Efficiency Under Medicare Advantage vs. Traditional...National News
The Medicare Payment Advisory Committee (MedPAC) released its 2023 summer data book on spending for the Medicare program. The report includes data across the program including demographics, access to care, quality of care metrics, dual-eligibility data, alternative payment models, and prescription drugs.
The Medicare program was the...
Last week, LeadingAge published a white paper that describes the difficulties Medicare Advantage members face accessing payment for post-acute care services.
The white paper, "Fulfilling the Promise: Medicare Advantage," identifies the issues that many beneficiaries face when attempting to access benefits, such as delays, unnecessary...
On Wednesday, the U.S. Department of Health and Human Services announced its timeline for the Medicare Drug Price Negotiation Program, a key point of legislation in the Inflation Reduction Act (IRA).
In a press call, Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure said that the department will...
As the nation grapples with a mental and behavioral health crisis, more Americans are using mental healthcare services covered by their insurers. New legislation seeks to facilitate that increase through requirements for Medicaid managed care organizations (MMOs) and Medicare Advantage (MA) plans.
New data from Blue Cross Blue Shield...
According to the Biden administration, the Inflation Reduction Act of 2022 will cap prescription drug costs for Medicare and also reduce health insurance premiums for hundreds of thousands of Arizona ACA beneficiaries by about $830 per year. The legislation is also expected to expand coverage to about 41,000 Arizonans, and cap insulin...
In response to the coronavirus, the Centers for Medicare and Medicaid Services (CMS) granted a special enrollment period (SEP) for Medicare beneficiaries through the end of June, giving Part D, Medicare Advantage and Medigap insurers an additional sales window. The SEP applies to those who were unable to enroll due to the pandemic....Arizona News
In a March 24 ruling, U.S. District Judge Michael Shea granted Medicare patients the constitutional right to challenge hospital decisions putting them on observation status. The class action case favored beneficiaries who had their status changed by hospitals to observation, despite having initially been admitted by...CMS Rules
This year, the Centers for Medicare and Medicaid Services (CMS) will implement a lower physician supervision requirement for hospital outpatient therapeutic services. CMS has required direct supervision of services such as, chemotherapy and radiation therapy for the past decade.
The change was finalized in November 2019, making...CMS Rules
Medicare open enrollment for 2020 coverage ended Saturday, Dec. 7, and while the Centers for Medicare and Medicaid Services (CMS) indicated a special enrollment period (SEP) for seniors who enrolled in a plan based on erroneous information, senators are calling for CMS to specify information regarding the SEP and make it available for...
