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Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging

Kaiser Health News

Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the government billions of dollars every year, government watchdogs told a House panel Tuesday. ” The health plan required patients to have an X-ray first to prove a CT scan was needed.

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CMS’ Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs

Healthcare Law Blog

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”). Refining Definitions for Fully Integrated and Highly Integrated D-SNPs (§§ 422.2

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While National Health Care Spending Growth Slowed in 2017, One Stakeholder’s Financial Burden Grew: The Consumer’s

Health Populi

National health care spending growth slowed in 2017 to the post-recession rate of 3.9%, down from 4.8% Per person, spending on health care grew 3.2% to $10,739 in 2017, and the share of GDP spent on medical care held steady at 17.9%. Underneath these macro-health economic numbers is the fact that inflation averaged 1.6%

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Cigna Ends Acquisition Talks with Humana, Announces $10B Share Repurchase Plan

HIT Consultant

What You Should Know: – Health insurer Cigna has called off its attempt to acquire rival Humana after failing to reach an agreement on price, according to sources familiar with the matter, CNBC first reports. This latest development highlights the ongoing challenges of consolidation in the sector.

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CVS Health in Talks to Acquire Signify Health

HIT Consultant

Wall Street has largely focused on CVS’s efforts to add primary-care practices and doctors to its payroll, though executives have also discussed their ambitions to expand its in-home health presence. Signify uses analytics and technology to help health plans, employers, physician groups and health systems with in-home care.

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New State Relief and Empowerment Waiver Guidance Gives States Tools to Help Fix Broken Health Insurance Markets

CMS.gov

New State Relief and Empowerment Waiver Guidance Gives States Tools to Help Fix Broken Health Insurance Markets. Administrator, Centers for Medicare & Medicaid Services. million Americans remain without health insurance. percent in 2019 and more insurers will enter the market—premiums are still far too high.

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Fifth Circuit Upholds ACA Risk Adjustment Program

Healthcare Law Blog

Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA), alleging, among other things, that its underlying methodology favors larger insurers. Once the new rules were published, Vista Health Plan, Inc., 2018 Final Rule, 83 Fed.

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