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...
Providers express support for MA prior authorization reform bill
By
Donna Shryer
Jun 16, 2024
Nursing home and senior living providers on Friday praised the newly introduced Improving Seniors’ Timely Access to Care Act, which would address the longstanding issue of prior authorization required...
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 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.
House committee approves bill that would reform prior authorization under Medicare Advantage program
By
Danielle Brown
Jul 29, 2022
Providers demanding change to the Medicare Advantage program may soon get their wish after a House panel advanced a measure that would reform the program’s prior authorization process.
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 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...
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...
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.
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.