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Capitation Rates Announcement for Medicare Advantage Plans for CY 2025

Innovaare Compliance

The Centers for Medicare & Medicaid Services (CMS) officially announced capitation rates for Medicare Advantage (MA) plans for CY 2025 – average increase of 3.7% The base beneficiary premium (BBP) will be capped at 6% from prior year from 2024 to 2029 [3]. The cost to Medicare Part D would be $26.8 billion [4].

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Monitor Improper Payments for Part C and Part D with Medicare Audit and Monitoring Software

Innovaare Compliance

The monthly premium for Medicare Part B rose 14.5%, from $148.50 By law, the Medicare Part B monthly premium must equal 25% of the estimated total Part B costs for enrollees age 65 and over. [1] By law, the Medicare Part B monthly premium must equal 25% of the estimated total Part B costs for enrollees age 65 and over. [1]

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Bonus Features – May 5, 2024 – Kaiser Permanente taps Innovaccer (and former CTO) for AI, report finds security flaws in Merge DICOM Toolkit, plus 18 more stories

Healthcare IT Today

It’s a big blow for Walmart, which according to Healthcare Dive initially set a goal in 2019 of opening 4,000 clinics by 2029. Intuity Medical received Medicare Part B coverage for POGO , its automatic blood glucose monitoring system.

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PBM Practices Receive Increased Federal Scrutiny

Healthcare Law Blog

In 2019, the Government Accountability Office and the Department of Health and Human Services Office of the Inspector General (“HHS OIG”) released reports finding that PBM-negotiated rebates lower prescription drug costs for Medicare Part D.

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Capitation Rates Announcement for CY 2025

Innovaare Compliance

The Centers for Medicare & Medicaid Services (CMS) officially announced capitation rates for Medicare Advantage (MA) plans for CY 2025 – average increase of 3.7% The base beneficiary premium (BBP) will be capped at 6% from prior year from 2024 to 2029 [3]. The cost to Medicare Part D would be $26.8 billion [4].

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Reduced Co-Insurance for Screening Colonoscopies

Medisys Compliance

For dates of service calendar years 2027-2029, the reduced coinsurance is 10%. For dates of service on or after calendar year 2030, Medicare waives the coinsurance. Background for Reduced Co-Insurance. These provisions are effective for services furnished on or after January 1, 2011.

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Rate Announcement for CY 2025

Innovaare Compliance

The Centers for Medicare & Medicaid Services (CMS) officially announced capitation rates for Medicare Advantage (MA) plans for CY 2025 – average increase of 3.7% The base beneficiary premium (BBP) will be capped at 6% from prior year from 2024 to 2029 [3]. The cost to Medicare Part D would be $26.8 billion [4].