Fierce Healthcare

OCTOBER 13, 2023

Approximately 42% of Medicare Advantage plans that offer prescription drug coverage will have a star rating of four or more in 2024, marking yet another substantial decrease from

Medicare 122

Medicare Medicare 122

Healthcare Dive

NOVEMBER 30, 2023

UnitedHealth’s MA growth could be depressed next year thanks to a rate notice from the CMS that’s deeply unpopular with insurers, management said during their investor day.

Medicare 306

Medicare Medicare 306

HealthIT Answers

AUGUST 29, 2023

By Chris Emper - On July 13, the Centers for Medicare & Medicaid Services released a 1,920-page proposed rule that would update payment policies and programs regarding Medicare payments to physicians and other providers under the Physician Fee Schedule on or after January 1, 2024.

Medicare 111

Medicare Medicare Medicaid Medicaid 111

Fierce Healthcare

JUNE 17, 2024

LAS VEGAS—The eyes of many regulators and lawmakers are on Medicare Advantage (MA), and, amid rising criticism of the program, one industry leader is making the case that "nostalgia" for traditiona | LAS VEGAS—The eyes of many regulators and lawmakers are on Medicare Advantage, and amid rising criticism of the program, one industry leader (..)

Medicare 107

Medicare Medicare 107

Healthcare Dive

FEBRUARY 7, 2024

The insurer on Wednesday joined its peers in slamming proposed MA payment rates as insufficient given the dogged increase in medical costs.

Medicare 290

Medicare Medicare 290

Fierce Healthcare

SEPTEMBER 26, 2023

Expect premiums, benefits and plan choices for Medicare Advantage (MA) and the Medicare Part D prescription drug program to look similar in 2024, the Centers for Medicare & Medicaid Services (C | CMS announced that nearly three-quarters of MA plan beneficiaries will not see their premiums rise.

Medicare 114

Medicare Medicare Medicaid Medicaid 114

Healthcare Dive

JUNE 14, 2024

The redo comes after regulators lost two court cases over the methodology used to determine 2024’s quality ratings, and should result in hundreds of millions of dollars in additional bonuses to plans that see their ratings improve.

Medicare 278

Medicare Medicare 278

Healthcare Dive

FEBRUARY 20, 2024

The big question coming out of the health insurance earnings season is how much elevated utilization among seniors will carry over into 2024.

Medicare 317

Medicare Medicare Health Insurance 317

Healthcare Dive

JANUARY 8, 2024

The payer is taking issue with how regulators calculated quality scores for 2024, after seeing a stars decline that could cause its bonus revenue to fall by $500 million.

Medicare 299

Medicare Medicare 299

Med Law Blog

NOVEMBER 6, 2023

CMS issued the Final Rule for the 2024 Medicare Physician Fee Schedule (PFS) on November 2, 2023, for payments to be effective on or after January 1, 2024. Fee Schedule Link The overall payment rates under the PFS will be reduced by 1.25% in calendar year 2024.

Medicare 52

Medicare Medicare 52

Fierce Healthcare

MARCH 4, 2024

Medicare Advantage (MA) growth has broadly slowed, but the biggest players in this space continue to claim the lion's share of this expansion, according to a new report from healthcare consultant C | Medicare Advantage growth has broadly slowed, but the biggest players in this space continue to claim the lion's share of this expansion, according (..)

Medicare 117

Medicare Medicare 117

Modern Healthcare

JULY 31, 2023

Skilled nursing faciltiies will receive a higher Medicare pay bump in fiscal 2024 than proposed by the Centers for Medicare and Medicaid Services in April.

Nursing Homes 80

Nursing Homes Medicare Medicare Nurses 80

Fierce Healthcare

JUNE 4, 2024

SCAN Health Plan secured a court victory Monday when a federal judge agreed that the Centers for Medicare & Medicaid Services (CMS) inappropriately calculated its star ratings for the 2024 plan | SCAN Health Plan secured a court victory Monday when a federal judge agreed that the Centers for Medicare & Medicaid Services inappropriately calculated (..)

Medicare 114

Medicare Medicare Medicaid Medicaid 114

Fierce Healthcare

JUNE 3, 2024

Blue Cross and Blue Shield of Kansas City is leaving the Medicare Advantage (MA) market at the end of 2024, the insurer announced recently. Blue Cross and Blue Shield of Kansas City is opting out of the Medicare Advantage market.

Medicare 120

Medicare Medicare 120

Med Law Blog

JULY 17, 2023

The 2024 Medicare Physician Fee Schedule proposes a 3.34% decrease in the 2024 PFS conversion factor. It’s currently $33.89 and is proposed to be reduced to $32.75.

Medicare 52

Medicare Medicare 52

Fierce Healthcare

MARCH 31, 2023

CMS to raise Medicare Advantage pay rates by 3.3% in 2024; phase in risk adjustment changes rking Fri, 03/31/2023 - 16:02

Medicare 133

Medicare Medicare 133

Innovaare Compliance

DECEMBER 11, 2023

Before the Medicare Advantage Open Enrollment Period (MA OEP) [1] begins on January 1, 2024, Medicare Advantage Organizations (MAOs) still have time to review if they are completely ready for a new contract year. This blog article focuses on some of the “must make” changes to take effect as of January 1, 2024, or before.

Medicare 52

Medicare Medicare Compliance Medicaid 52

HealthIT Answers

AUGUST 12, 2023

On August 1, 2023, the CMS issued the fiscal year 2024 Medicare hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. The final rule updates Medicare fee-for-service payment rates and policies for inpatient hospitals and LTCHs for FY 2024.

Medicare 52

Medicare Medicare Hospitals Payment Systems 52

HealthIT Answers

MARCH 11, 2024

RISE National: Downtown Nashville, March 17-19, 2024. The trusted source for all things Medicare Advantage, crossing a variety of topics and themes from risk adjustment and quality to member experience and social determinants of health. The post RISE National 2024 appeared first on Health IT Answers.

Medicare 64

Medicare Medicare 64

HealthIT Answers

MAY 29, 2024

CMS announces that the Medicare Promoting Interoperability Program calendar year 2023 Hardship Exception application period is now open as of May 1, 2024. The post Medicare PI Program Hardship Exception Applications Are Now Open appeared first on Health IT Answers.

Medicare 59

Medicare Medicare Hospitals 59

Healthcare Dive

DECEMBER 22, 2023

A shift in funding sources, new regulatory policies in Medicare and technology advances may influence M&A in the sector next year, according to Samantha Prokop from law firm Gunster, Yoakley & Stewart.

Medicare 274

Medicare Medicare 274

Fierce Healthcare

FEBRUARY 1, 2023

CMS proposes small hike to Medicare Advantage, Part D plan payments in 2024 amid risk adjustment changes rking Wed, 02/01/2023 - 17:35

Medicare 107

Medicare Medicare 107

Innovaare Compliance

OCTOBER 31, 2023

2024 Star Ratings , which CMS released on Oct 13 th , 2023, has forced the industry to deeply introspect and re-strategize the path forward with newer evaluation dynamics at play. More membership was distributed across lower Star ratings in 2024 compared to 2023. ” (replace life with Star ratings!)

Medicare 52

Medicare Medicare Compliance 52

Fierce Healthcare

JANUARY 12, 2023

MedPAC calls for slight pay update to 2024 Medicare rates for hospitals, physicians. Thu, 01/12/2023 - 14:33.

Medicare 98

Medicare Medicare Hospitals 98

Fierce Healthcare

OCTOBER 2, 2023

Independence Blue Cross unveiled Medicare Advantage (MA) packages that the company said will greatly enhance benefits for its MA members, including a bigger allowance for vision, dental, hearing an | The MA enhancements touted by Independence Blue Cross include reducing premiums for its Personal Choice 65 PPO while including a Part B giveback and a (..)

Medicare 107

Medicare Medicare 107

Fierce Healthcare

SEPTEMBER 29, 2023

The industry is just two weeks away from the beginning of Medicare's annual enrollment period, a critical window for the hottest market in insurance. | The industry is just two weeks away from the beginning of Medicare's annual enrollment period, a critical window for the hottest market in insurance.

Medicare 117

Medicare Medicare 117

Hall Render

DECEMBER 12, 2023

On November 16, 2023, the Centers for Medicare & Medicaid Services (“CMS”) published proposed changes to the Medicare provider enrollment requirements in the Calendar Year 2024 Physician Fee Schedule final rule (“Final Rule”).

Medicare 40

Medicare Medicare Licensing Malpractice 40

Healthcare Dive

JANUARY 31, 2024

The payer is leveraging CenterWell’s growing network of primary care centers for seniors to boost margins in its hard-pressed Medicare Advantage business.

Medicare 147

Medicare Medicare 147

Healthcare Law Blog

AUGUST 11, 2023

On July 13, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its proposed rule (the “Proposed Rule”) for the 2024 Medicare Physician Fee Schedule (“PFS”). CMS projects that the Proposed Rule will lead to growth in the Medicare Shared Savings Program (“MSSP”).

Medicare 52

Medicare Medicare Nurses Medicaid 52

Fierce Healthcare

DECEMBER 18, 2023

Payers need to properly adapt to changes made to the Medicare Advantage star ratings program or risk financial repercussions, industry experts told Fierce Healthcare. Payers are being urged to prioritize health equity considerations more than ever before to improve their Medicare Advantage star ratings scores.

Medicare 114

Medicare Medicare 114

Fierce Healthcare

JANUARY 8, 2024

For the 2023 plan year, Aetna's performance in the annual Medicare Advantage star ratings took a massive hit, with just 21% of its members enrolled in plans that earned a score of four stars or mor | After a rough showing a year ago, Aetna bounced back for 2024, and was one of the stronger performers in the latest star ratings.

Medicare 110

Medicare Medicare 110

Hall Render

NOVEMBER 29, 2023

On November 2, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued the 2024 Medicare Physician Fee Schedule Final Rule (“Final Rule”) for calendar year (“CY”) 2024. These changes become effective on January 1, 2024.

Medicare 40

Medicare Medicare Nurses Payment Systems 40

Health Care Law Brief

APRIL 3, 2023

On Friday, March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies ( Rate Announcement ). 1395w-23): Medicare Advantage Organizations (MAOs) are paid a base rate by CMS. Risk Adjustment.

Medicare 52

Medicare Medicare Overpayments Overpayment 52

HealthIT Answers

APRIL 8, 2024

By Beth Friedman - RISE National 2024: Regardless of the speaker, track, or motivation, the overarching theme of all discussions was trust. Trust is vital for problem-solving in healthcare especially true for the Medicare Advantage program.

Medicare 59

Medicare Medicare 59

HealthIT Answers

FEBRUARY 5, 2024

CMS announced increased participation in CMS’ accountable care organization initiatives in 2024, which will increase the quality of care for more people with Medicare. Of note, CMS is announcing that 19 newly formed ACOs in the Medicare Shared Savings Program are participating in new, permanent payment option beginning in 2024.

Medicare 59

Medicare Medicare 59

Healthcare Dive

NOVEMBER 2, 2022

Beginning in January 2024, ACOs that don’t have experience with performance-based risk will be able to stay in a one-sided risk arrangement for up to seven years before transitioning to two-sided risk.

Medicare 299

Medicare Medicare 299

Med Law Blog

JULY 11, 2024

Click here for the CMS Announcement on July 10, 2024 proposing a reduction in the Medicare Conversion Factor payment from $33.29 to $32.36, i.e. 2.8% There are a host of other changes in the 24 page Release, which we will address in due course.

Medicare 40

Medicare Medicare 40