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...
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.
Justice Department investigating Humana billing practices
By
John Hall
Feb 24, 2015
Humana Inc. reports that it is cooperating with a Department of Justice inquiry into whether it exaggerated the severity of elderly patients’ illnesses to generate higher Medicare reimbursements.
House committee subpoenas HHS over Medicare Advantage demonstration project
By
McKnight's Staff
Oct 23, 2012
Rep. Darrell Issa (R-CA) and other House Republicans issued a subpoena Monday to gain access to documents related to an Affordable Care Act Medicare Advantage demonstration project.
As Medicare Advantage grows, experts say, so do hard-to-fight denials
By
Kimberly Marselas
May 19, 2022
In addition to sagging Medicare Advantage payment rates, some skilled nursing providers also find themselves routinely doing battle to get paid for services they’ve already delivered.
CMS eyes 8% revenue increase for Medicare Advantage
By
Danielle Brown
Feb 04, 2022
The Centers for Medicare & Medicaid Services is forecasting a nearly 8% increase in revenue for Medicare Advantage plans next year. The agency released its 2023 advance notice earlier this week.
Group wants feds to probe Medicare Advantage plans wrongly denying care
By
Danielle Brown
May 25, 2022
An influential group of healthcare providers is calling on the Department of Justice to investigate Medicare Advantage organizations that have been found wrongly denying services to beneficiaries.
Providers warned not to interfere with resident healthcare coverage choices after $8 million settlement
By
Danielle Brown
Jul 13, 2022
The nation’s largest nursing home association is urging providers to properly educate staff on acceptable practices when it comes to discussing changes to residents’ healthcare coverage in order to...