Flurry of Medicare Advantage regulation likely to hit nursing home coffers
By
Kimberly Marselas
Feb 03, 2023
Federal efforts to rein in Medicare Advantage spending and recoup payments awarded for improper diagnoses will likely lead to even more financial pressure on nursing homes that serve plan beneficiaries,...
CMS finalizes long-awaited prior authorization rule for Medicare Advantage
By
Josh Henreckson
Jan 18, 2024
A new rule on Medicare Advantage prior authorization finalized by the Centers for Medicare & Medicaid Services Wednesday suggests good news for providers and Medicare recipients.
Lawmakers pushing CMS to ease Medicare Advantage prior authorizations
By
Kimberly Marselas
Jun 26, 2023
Close to 300 members of Congress are urging federal regulators to do more to reduce burdensome Medicare Advantage requirements that can slow delivery of care to nursing home and other patients.
Also in the News for Tuesday, Mar. 5, 2024
By
Kimberly Marselas
Mar 05, 2024
On the Move: Consulate appoints new COO … Former CMS head says MA plans are gaming the system … Too many skilled nursing websites show performance, access problems, audit warns … Legionaire’s case...
CMS completes minimum staffing study; targeting ‘onerous’ MA authorizations
By
Kimberly Marselas
Jan 25, 2023
Two proposed rules should help patients improve their Medicare Advantage plan selections while standardizing expectations for skilled nursing and other healthcare providers, federal officials reiterated...
‘Death spiral’ for SNFs as Medicare Advantage pay decreases
By
Kimberly Marselas
Sep 06, 2022
Pressure to accept low-ball contracts with Medicare Advantage plans that continue to reduce reimbursement is driving some skilled nursing providers into “a death spiral,” a major aging services association...
‘Impossible’ Medicare Advantage denials decried during Senate hearing
By
Kimberly Marselas
May 18, 2023
A Senate subcommittee Wednesday sent letters to the nation’s largest Medicare Advantage insurers, demanding they reveal internal documents that illustrate how they make coverage determinations.
MA plans pocket billions more by enrolling less-costly patients
By
Kimberly Marselas
Jun 16, 2023
Medicare Advantage plans may be receiving overpayments of as much as 20%, finds a new study published by a health and aging think tank.
Clinical briefs for Tuesday, March 21
By
Alicia Lasek
Mar 20, 2023
LeadingAge: MA program failures jeopardize health of nearly 30 million older adults … Behavioral health is crucial ingredient in new Michigan home care program … Patients prefer to see test results...
Another week, more Medicare dis-Advantages
By
Kimberly Marselas
Aug 22, 2023
It’s starting to feel like every week brings another reason to begrudge Medicare Advantage plans their market-dominating growth.