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...
Medicare Advantage slowing COVID discharges to SNFs: report
By
Kimberly Marselas
Sep 02, 2021
A new report finds Medicare Advantage restrictions are also creating log jams in hospitals desperate to discharge patients to post-acute care and free up needed beds.
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.
Medicare Advantage plans forcing providers to take ‘optional’ payment reductions
By
Kimberly Marselas
Nov 15, 2022
Many skilled nursing providers are still underusing Interim Payment Assessments under the nascent Patient Drive Payment Model, but one new pressure is driving some to submit those extra patient evaluations...
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.
Medicare Advantage funding could be cut
By
John Hall
Feb 09, 2015
Supporters of Medicare Advantage program are roundly criticizing President Obama’s fiscal 2016 budget plan to slash more than $36 billion in its funding over the coming decade.
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.
Medicare Advantage set for regulatory showdown as penetration passes 50 percent
By
Kimberly Marselas
May 16, 2023
After years of explosive growth, Medicare Advantage crossed a major tipping point in January: More than 50% of all Medicare beneficiaries are now covered by an MA plan.
As Medicare Advantage drives rate lower, fed-up CEOs embrace strategies that limit carriers’ influence
By
Kimberly Marselas
Apr 26, 2021
Medicare Advantage’s aggressive market penetration represents a major threat to skilled nursing providers, some of whom now find themselves clearing less per resident day through MA plans than they do...
Fogg clears the air on skilled nursing ‘tailwinds’
By
James M. Berklan
Oct 26, 2023
The headwinds for skilled nursing operators are significantly more numerous than the potential tailwinds, but there are reasons for provider optimism.