CMS nudges beneficiaries away from low-performing MA plans
By
McKnight's Staff
Nov 07, 2012
The Centers for Medicare & Medicaid Services is encouraging around 375,00 Medicare Advantage members to re-evaluate their plans.
CMS pledges to use ‘full array’ of tools to enforce 2024 Medicare Advantage rules
By
Josh Henreckson
Jan 12, 2024
Despite early fears, long-term care leaders have some reason to be optimistic that changes to Medicare Advantage rules for 2024 will be enforced.
How often do health insurers say no to patients? No one knows.
By
Robin Fields/ProPublica
Jun 29, 2023
It’s one of the most crucial questions people have when deciding which health plan to choose: If my doctor orders a test or treatment, will my insurer refuse to pay for it?
CMS proposal offers long-awaited fix for Medicare Advantage appeals
By
Kimberly Marselas
Nov 08, 2023
Skilled nursing providers would get a new, improved appeals process for Medicare Advantage denials under a proposal issued late Monday by the Centers for Medicare & Medicaid Services.
MA enrollees with dementia report poor quality of care: study
By
Alicia Lasek (f3)
May 09, 2022
Medicare Advantage plans will be more incentivized to address gaps in care if consumer care assessments include more input from enrollees with dementia, investigators say.
Medicare Advantage plan settles upcoding allegations for $22.5M
By
Kimberly Marselas
Aug 02, 2023
A Medicare Advantage plan will pay $22.5 million to settle allegations that it systematically reviewed patient charts to tack on additional charges before submitting claims to Medicare, federal law enforcement...
Lawmakers reignite attacks against ‘scam’ Medicare Advantage plans
By
Jessica R. Towhey
Jul 27, 2023
Federal lawmakers and activists are turning up the heat again on Medicare Advantage, a month after 300 members of Congress told the federal agency that oversees the system to make it easier to manage.
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.