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.
Medicare Advantage retaining sicker patients with more complex health needs: study
By
Alicia Lasek
Jun 29, 2023
After years of criticism for cherry-picking healthier people for enrollment, Medicare Advantage is now holding onto more patients with chronic conditions, investigators say.
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?
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.
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.
‘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.
Nursing homes have to fight for pay protections in Medicare Advantage rule: expert
By
Kimberly Marselas
Apr 27, 2023
Providers must play an active role in stopping aggressive Medicare Advantage practices that have for years limited access to skilled nursing care, a top managed care expert warned administrators gathered...
More nursing homes should provide residents with I-SNP option
By
John Capasso
Apr 17, 2023
The Medicare Modernization Act of 2003 established a Medicare Advantage Coordinated Care Plan intended for individuals with special care needs, including nursing home residents with lengths of stay over...
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...
As CMS tightens vise on Medicare Advantage, providers argue for even more help
By
Kimberly Marselas
Feb 15, 2023
Forty-five days after proposing changes that attempt to rein in some of the most-criticized practices of Medicare Advantage plans, federal officials now must filter through nearly 1,000 formal comments.