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.
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.
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.
A crazy way to spend a healthcare fortune
By
James M. Berklan
Dec 01, 2023
I’d like to announce that the folks who run Medicare Advantage plans will be shaking in their boots soon, fearful of what authorities are going to do to them.
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...