Disenrolling residents from MA plans leads to $7.85 million provider settlement with feds
By
Danielle Brown
Jul 01, 2022
A New York-based provider is settling allegations that it switched resident’s Medicare coverage to maximize its reimbursements for nearly $8 million.
Federal officials keep heat on MA plans over denials, delays
By
Danielle Brown
Jun 30, 2022
Congressional lawmakers are being urged to address weaknesses in Medicare Advantage plans in response to a federal watchdog report that found that the MA organizations have often improperly denied or delayed...
Group wants feds to probe Medicare Advantage plans wrongly denying care
By
Danielle Brown
May 25, 2022
An influential group of healthcare providers is calling on the Department of Justice to investigate Medicare Advantage organizations that have been found wrongly denying services to beneficiaries.
As Medicare Advantage grows, experts say, so do hard-to-fight denials
By
Kimberly Marselas
May 19, 2022
In addition to sagging Medicare Advantage payment rates, some skilled nursing providers also find themselves routinely doing battle to get paid for services they’ve already delivered.
Providers demand fixes after feds find MA plans wrongly delay or deny SNF services too often
By
Danielle Brown
May 02, 2022
Skilled nursing providers are demanding changes after a new federal report found that Medicare Advantage organizations (MAOs) have improperly denied or delayed services to beneficiaries to increase profits.
CMS eyes 8% revenue increase for Medicare Advantage
By
Danielle Brown
Feb 04, 2022
The Centers for Medicare & Medicaid Services is forecasting a nearly 8% increase in revenue for Medicare Advantage plans next year. The agency released its 2023 advance notice earlier this week.
Justice Department investigating Humana billing practices
By
John Hall
Feb 24, 2015
Humana Inc. reports that it is cooperating with a Department of Justice inquiry into whether it exaggerated the severity of elderly patients’ illnesses to generate higher Medicare reimbursements.
CMS to hold Medicare Advantage conference
Jun 12, 2014
The Centers for Medicare & Medicaid Services will hold its Medicare Advantage & Prescription Drug Oversight & Enforcement 2014 Program Audits conference on Tuesday, June 24 .It is designed to “provide...
House committee subpoenas HHS over Medicare Advantage demonstration project
By
McKnight's Staff
Oct 23, 2012
Rep. Darrell Issa (R-CA) and other House Republicans issued a subpoena Monday to gain access to documents related to an Affordable Care Act Medicare Advantage demonstration project.
Report: Correcting Medicare Advantage overpayments could save billions
Jan 27, 2012
Correcting overpayments in the Medicare Advantage program could save the federal government billions of dollars, according to a new Government Accountability Office report.