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...
Affordable Care Act will reduce Medicare Advantage overpayments by $132 billion, Commonwealth Fund report...
By
McKnight's Staff
Oct 18, 2012
Affordable Care Act reforms to Medicare Advantage (MA) will save the federal government $132 billion over 10 years, a new analysis has found.
Fraud-fighting efforts not much to brag about
By
John O'Connor
Nov 30, 2012
In what has become a frequent event, the Inspector General at the Department of Health and Human Services has just issued yet another report that crows about heroic fraud-fighting efforts.
Report: Improper Medicare Advantage payments fell $1.2 billion in 2011
By
McKnight's Staff
Apr 02, 2012
Recovery audit contractors and other quality assurance efforts allowed Medicare Advantage to reduce improper payments by $1.2 billion in 2011, according to a new government report.
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.
CMS nudges beneficiaries away from low-performing MA plans
By
McKnight's Staff
Nov 07, 2012
The Centers for Medicare & Medicaid Services is encouraging around 375,00 Medicare Advantage members to re-evaluate their plans.
MA enrollees with dementia report poor quality of care: study
By
Alicia Lasek (f3)
May 09, 2022
Medicare Advantage plans will be more incentivized to address gaps in care if consumer care assessments include more input from enrollees with dementia, investigators say.
Jimmo correction: Assistants may provide maintenance services in skilled nursing facilities
By
Tim Mullaney
Jan 17, 2014
Skilled nursing facilities may be reimbursed for maintenance therapy services performed by assistants, the Centers for Medicare & Medicaid Services clarified in a recent Medicare Benefit Policy manual...
Analysts break ground with first batch of SNF Medicare Advantage data
By
James M. Berklan
Oct 11, 2021
Managed care plans typically hold all the cards when it comes to rate-setting. But a new way of analyzing billing data could finally give increasingly leveraged providers a better leg to stand on, financial...
Low-quality Medicare Advantage plans should expect scrutiny, CMS says
By
McKnight's Staff
Apr 13, 2012
Medicare Advantage plans with fewer than five stars on the quality scale should expect some form of audit, a Centers for Medicare & Medicaid official said this week.