Healthcare IT Today

FEBRUARY 22, 2023

There’s widespread consensus that payments to Medicare Advantage Organizations (MAOs) are a mess. Here, we adopt a position sympathetic to the hurdles facing Medicare Advantage plans and look at how they are trying to improve the quality of data.

Medicare 89

Medicare Medicare Overpayments Overpayment 89

Healthcare Dive

MARCH 7, 2023

The plan — part of Biden’s 2024 budget proposal set to be released Thursday — would further reduce what Medicare pays for prescription drugs and raise taxes on Americans earning over $400,000

Medicare 278

Medicare Medicare 278

Healthcare Dive

FEBRUARY 10, 2023

The CMS has laid out how it plans to implement a key provision of the Inflation Reduction Act requiring drugmakers to pay rebates on price hikes in Medicare that are greater than inflation

Medicare 273

Medicare Medicare 273

Healthcare Dive

DECEMBER 20, 2022

The Government Accountability Office is urging the CMS to resume certain eligibility checks on providers whom they consider at high risk of fraud to the Medicare program

Governance 275

Governance Fraud Medicare Medicare 275

Healthcare Dive

OCTOBER 31, 2022

Under the changes, traditional Medicare coverage will kick in the month immediately after enrolling

Medicare 278

Medicare Medicare 278

Healthcare Dive

JANUARY 31, 2023

America’s Health Insurance Plans lobby said the rule seeking to claw back billions of dollars from health insurers is unlawful and fatally flawed

Medicare 237

Medicare Medicare Health Insurance 237

Healthcare Dive

SEPTEMBER 9, 2022

A small proportion of providers that billed for telehealth — 1,714 out of 742,000 — posed a high risk of fraud or abuse to Medicare in COVID-19’s first year, regulators found

Fraud 253

Fraud Medicare Medicare COVID-19 253

Electronic Health Reporter

JANUARY 12, 2022

The article How To Market to Medicare Patients appeared first on electronichealthreporter.com. Editorial How To Market to Medicare Patients Ways to Market to Medicare PatientsThis article is copyrighted strictly for Electronic Health Reporter. Illegal copying is prohibited. Nowadays our lives are engulfed with advertisements from gigantic billboards on the streets to our TVs to pop-ups online. That saturation can make useful information hard to find.

Medicare 133

Medicare Medicare 133

Healthcare Dive

DECEMBER 20, 2022

Lawmakers are rushing to speed passage of the $1.7 trillion omnibus spending package as they near a Friday deadline for government funding

Medicaid 316

Medicaid Medicaid Medicare Medicare 316

Compliancy Group

MARCH 8, 2023

are missing out on most of these opportunities because their names are on the HHS OIG (Health and Human Services, Office of Inspector General) Medicare Exclusion List. Believe it or not, there are those who don’t know they are on the Medicare Exclusion List.

Medicare 52

Medicare Medicare Fraud Licensing 52

Healthcare Dive

AUGUST 26, 2022

The Inflation Reduction Act leaves intact a peculiar split in Medicare vaccine coverage that discourages physicians from offering certain vaccines, argues former Moderna Vice President Richard Hughes

Medicare 291

Medicare Medicare 291

Healthcare Dive

FEBRUARY 28, 2022

The decision to retain the direct contracting model — albeit with numerous changes and a new name — was met with mixed reactions from stakeholders

Medicare 307

Medicare Medicare 307

Electronic Health Reporter

SEPTEMBER 12, 2022

The article How Modern Technology Revolutionizes Medicare Buying Process appeared first on electronichealthreporter.com. Editorial buying Medicare Medicare buyingThis article is copyrighted strictly for Electronic Health Reporter. Illegal copying is prohibited.

Medicare 91

Medicare Medicare 91

Kaiser Health News

JUNE 29, 2022

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. Bliss said Medicare paid $2.6

Governance 122

Governance Medicare Medicare US Department of Health and Human Services 122

Kaiser Health News

NOVEMBER 11, 2021

Finding the best private Medicare drug or medical insurance plan among dozens of choices is tough enough without throwing misleading sales tactics into the mix. The problems are especially prevalent during Medicare’s open-enrollment period, which began Oct.

Medicare 145

Medicare Medicare Fraud Doctors 145

Healthcare Dive

DECEMBER 19, 2022

Proposed changes target prior authorization holdups and misleading advertising while aiming to expand access to behavioral health care and affordable prescriptions

Medicare 260

Medicare Medicare 260

Healthcare Dive

MAY 18, 2022

Florida, West Virginia and South Carolina had relative prices at or above 310% of Medicare prices, according to the report Rand researchers also found wide price variations across states.

Medicare 299

Medicare Medicare Hospitals 299

The Health Law Firm Blog

AUGUST 23, 2022

Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals. By George F. Indest III, J.D., M.P.A., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare Dive

AUGUST 24, 2022

The Better Medicare Alliance is arguing that marketing materials for MA plans are already subject to “careful regulation” and adhere to a 53-page set of federal guidelines

Medicare 232

Medicare Medicare 232

Healthcare Dive

MAY 23, 2022

The hospital lobby is pushing the Justice Department to go beyond the recommendations in a new report from the HHS OIG and punish Medicare Advantage organizations that routinely deny coverage to beneficiaries

Medicare 281

Medicare Medicare Hospitals 281

Healthcare Dive

JUNE 22, 2022

The justices declined to take up the case, leaving intact a lower court ruling that backed the 2014 CMS regulation requiring swift return of overpayments

Overpayments 308

Overpayments Overpayment Medicare Medicare 308

Healthcare Dive

JANUARY 24, 2023

Rush University will be the only Chicago-area academic medical center participating in CVS’ first accountable care organization in ACO REACH

Medicare 216

Medicare Medicare 216

Healthcare Dive

JUNE 27, 2022

The highest court upheld HHS' method of calculating Medicare payments to hospitals serving a high proportion of low-income patients, rebutting hospitals’ efforts to recoup potentially billions of dollars from the program

Medicare 267

Medicare Medicare Hospitals 267

Electronic Health Reporter

JANUARY 27, 2021

The Centers for Medicare and Medicaid Services (CMS) in recent months predicted both lower premiums and richer benefits for Medicare Advantage (MA) […]. The article 2021 Medicare Advantage Plan Intelligence: An Early Look appeared first on electronichealthreporter.com.

Medicare 155

Medicare Medicare Medicaid Medicaid 155

Fierce Healthcare

DECEMBER 20, 2022

Medicare-certified hospitals must supply ownership data. fdiamond. Tue, 12/20/2022 - 16:46

Medicare 128

Medicare Medicare Hospitals 128

Healthcare Dive

AUGUST 8, 2022

The Inflation Reduction Act looked dead just weeks ago until Sen. Joe Manchin, D-W.Va., announced late last month that he had successfully negotiated with Democrats to pass it

ACA 287

ACA Medicare Medicare 287

Healthcare Dive

FEBRUARY 9, 2022

The second-largest player slashed its MA growth forecast for the year as startup insurtechs report membership gains

Medicare 237

Medicare Medicare 237

HealthIT Answers

AUGUST 22, 2022

By Chris Emper - The heavily anticipated CMS 2023 Proposed Medicare Physician Payment Rule is a whopping 2,066 pages long and includes numerous provisions that will impact physician groups next year. Regulatory Issues Chris Emper CMS Medicare Medicare Physician Fee Schedule NextGen Healthcar

Medicare 98

Medicare Medicare 98

Healthcare Dive

NOVEMBER 15, 2022

The Medical Group Management Association wants Congress to take action to help physician practices by the end of the year

Medicare 243

Medicare Medicare 243

Healthcare Dive

APRIL 29, 2022

The report calls for improved oversight of MA and urges the CMS to update audit protocols and issue new guidance on medical necessity reviews performed by the plans

Medicare 311

Medicare Medicare 311

Fierce Healthcare

OCTOBER 13, 2022

House progressive bill wants to take Medicare out of Medicare Advantage's name. rking. Thu, 10/13/2022 - 16:45

Medicare 133

Medicare Medicare 133

Healthcare Dive

AUGUST 1, 2022

The agency wants feedback from a variety of voices on how it can strengthen the popular but increasingly controversial program

Medicare 278

Medicare Medicare 278

HIT Consultant

OCTOBER 13, 2022

Medicare Advantage Plan for LGBTQ+ Older Adults. Health IT Most Popular Behavioral Healthcare Health Disparities medicare Medicare Advantage urgent care Virtual Care Virtual Visits

Medicare 95

Medicare Medicare 95

Fierce Healthcare

FEBRUARY 15, 2023

Better Medicare Alliance launches bid to get rid of potential Medicare Advantage pay cut rking Wed, 02/15/2023 - 15:34

Medicare 98

Medicare Medicare 98

Fierce Healthcare

FEBRUARY 16, 2023

Analysis: Medicare Advantage plans more likely to deny inpatient claims pminemyer Thu, 02/16/2023 - 14:16

Medicare 131

Medicare Medicare 131