MA enrollees receive less intensive end-of-life care, study finds
By
Donna Shryer
Jul 21, 2024
A new study published in JAMA Health Forum reports that Medicare Advantage (MA) enrollees receive less intensive end-of-life care compared to those in traditional Medicare (TM). To identify this conclusion,...
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 official to providers: Help us capture data to drive Medicare Advantage reforms
By
James M. Berklan
Mar 07, 2024
The increased use of health data and providers’ own voices should be considered among the best tools available for achieving change in a system that increasingly relies on Medicaid Advantage and other...
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 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.
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.
Also in the News for Tuesday, Mar. 5, 2024
By
Kimberly Marselas
Mar 05, 2024
On the Move: Consulate appoints new COO … Former CMS head says MA plans are gaming the system … Too many skilled nursing websites show performance, access problems, audit warns … Legionaire’s case...
Another week, more Medicare dis-Advantages
By
Kimberly Marselas
Aug 22, 2023
It’s starting to feel like every week brings another reason to begrudge Medicare Advantage plans their market-dominating growth.