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...
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...
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...
Baseline proficiency for success with managed care payers
By
Susie Mix
Mar 11, 2024
Setting up a building with proficiencies in working with managed care payers is a key to success at this midpoint of the 2020s. Fifty-one percent of Medicare-eligible Americans are covered by Medicare...
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.
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.
A Medicare Advantage fix: What took so long?
By
James M. Berklan
Apr 12, 2024
Providers hoping that policy makers might some day show some backbone when dealing with Medicare Advantage plans can take heart. Well, at least a little.
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.
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.