Lawmakers say CMS should ban Medicare Advantage’s use of AI to deny care
By
Josh Henreckson
Jun 26, 2024
The Centers for Medicare & Medicaid Services should consider banning artificial intelligence from being used to deny Medicare Advantage coverage pending a “systematic review,” a group of 49 congressional...
Study: Medicare Advantage low on psychiatrists; some areas don’t even offer them
By
Kristen Fischer
Jul 07, 2023
Demand is growing for mental health care in older adults, but Medicare Advantage (MA) networks lack enough psychiatrists to help, a new study found.
CMS pledges to use ‘full array’ of tools to enforce 2024 Medicare Advantage rules
By
Josh Henreckson
Jan 12, 2024
Despite early fears, long-term care leaders have some reason to be optimistic that changes to Medicare Advantage rules for 2024 will be enforced.
Less post-acute care worsens outcomes, Medicare Advantage patients reveal in new study
By
Kimberly Marselas
Aug 21, 2023
Fewer Medicare Advantage enrollees report using post-acute care services than traditional Medicare beneficiaries. But even when they do use them, a new study finds that those MA patients report more undesirable...
Flurry of Medicare Advantage regulation likely to hit nursing home coffers
By
Kimberly Marselas
Feb 03, 2023
Federal efforts to rein in Medicare Advantage spending and recoup payments awarded for improper diagnoses will likely lead to even more financial pressure on nursing homes that serve plan beneficiaries,...
Demand for I-SNP coverage drives Longevity’s growth
By
Kimberly Marselas
Jan 17, 2022
Explosive growth for Longevity Health Plan’s I-SNPs underscores skilled nursing providers’ increasing willingness to partner for patient care, especially if partners add clinical capabilities and...
As CMS tightens vise on Medicare Advantage, providers argue for even more help
By
Kimberly Marselas
Feb 15, 2023
Forty-five days after proposing changes that attempt to rein in some of the most-criticized practices of Medicare Advantage plans, federal officials now must filter through nearly 1,000 formal comments.