Lawmakers say CMS should ban Medicare Advantage’s use of AI to deny care
By
Josh Henreckson
Jun 26, 2024
The Centers for Medicare & Medicaid Services should consider banning artificial intelligence from being used to deny Medicare Advantage coverage pending a “systematic review,” a group of 49 congressional...
Sector, consumer advocates vent shared frustrations on Medicare Advantage lack of transparency to CMS
By
Josh Henreckson
Jun 02, 2024
Long-term care leaders and consumer advocates — often at odds over nursing home policy — have voiced their shared frustrations about Medicare Advantage plans to the Centers for Medicare & Medicaid...
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.
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.
Long-term care leaders cheer proposed Medicare Advantage appeals rule in final push
By
Josh Henreckson
Jan 08, 2024
A surge of public and professional support arrived Friday as the comment period closed for a proposed federal rule that providers say could level the playing field with Medicare Advantage plans.
Understanding facility, peer data called crucial to better Medicare Advantage negotiations
By
Josh Henreckson
Mar 27, 2024
Nursing homes have historically had little leverage in negotiations with Medicare Advantage plans, even as MA has come to cover an ever-larger number of skilled nursing beneficiaries.