Healthcare Dive

MARCH 5, 2024

Medicare Advantage beneficiaries were also less likely to improve self-care and mobility function, according to research published in JAMA Health Forum.

Medicare 313

Medicare Medicare 313

Healthcare Dive

MAY 7, 2024

The Medicare trustee’s new deadline for the trust fund’s insolvency is five years later than in last year’s report, but budget hawks warned action is still needed to shore up the insurance program’s finances.

Medicare 290

Medicare Medicare 290

Healthcare Dive

SEPTEMBER 5, 2023

The payer, which brings in the bulk of its revenue from Medicare, is fighting back against a rule finalized earlier this year to claw back overpayments in the increasingly popular MA program.

Medicare 306

Medicare Medicare Overpayments Overpayment 306

Healthcare Dive

APRIL 3, 2023

The date Medicare’s hospital trust fund is expected to run dry has been extended by three years, but stakeholders continue to urge action from Washington to address Medicare’s long-term solvency.

Medicare 321

Medicare Medicare Hospitals 321

Healthcare Dive

SEPTEMBER 22, 2023

CMS Deputy Administrator Jon Blum signaled regulators could increasingly crack down on bad actors in the MA program, which now covers more than half of Medicare seniors.

Medicare 325

Medicare Medicare 325

Healthcare Dive

JANUARY 16, 2024

MedPAC released the data Friday during a contentious meeting where members argued over the efficacy of Medicare Advantage.

Medicare 340

Medicare Medicare 340

Healthcare Dive

JUNE 14, 2024

The House Budget Committee met Thursday and said they’d take action to restore Medicare’s financial footing, though the hearing was light on specifics.

Medicare 162

Medicare Medicare 162

Healthcare Dive

JUNE 17, 2024

Healthcare payers are leveraging automation and technology to build robust Medicare Advantage networks, overcoming challenges posed by changing deadlines and regulatory complexities.

Medicare 147

Medicare Medicare 147

Healthcare Dive

NOVEMBER 3, 2023

Regulators finalized a number of rules Thursday with sweeping implications for providers in the Medicare program, including rates for next year that doctors and hospitals slammed as insufficient.

Doctors 309

Doctors Medicare Medicare Hospitals 309

Healthcare Dive

JUNE 14, 2023

The figure is almost triple prior estimates of MA overpayments, highlighting the need for payment reform to avoid overtaxing the Medicare system, researchers said.

Overpayments 290

Overpayments Overpayment Medicare Medicare 290

Healthcare Dive

FEBRUARY 27, 2024

Medicare Advantage payment per month, per beneficiary could drop by 1% next year if regulators finalize rates as proposed, according to the analysis backed by the Better Medicare Alliance.

Medicare 279

Medicare Medicare 279

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.

Fraud 326

Fraud Governance Medicare Medicare 326

Healthcare Dive

JANUARY 30, 2024

However, growth in Medicare's flagship shared savings model has plateaued over the past five years, according to government data.

Medicare 189

Medicare Medicare Governance 189

Fierce Healthcare

JULY 11, 2024

A recent lawsuit has pushed back against an industry-opposed Centers for Medicare & Medicaid Services (CMS) final rule on broker compensation in Medicare Advantage (MA) plans. | A district court in Texas is halting a federal rule that changes broker compensation and overhauls marketing to seniors.

Medicare 120

Medicare Medicare Medicaid Medicaid 120

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 279

Medicare Medicare 279

Fierce Healthcare

JUNE 26, 2024

Medicare enrollees will pay less for 64 prescription drugs from July though the end of September because drug companies raised prices faster than the rate of inflation, the Centers for Medicare &am | Medicare enrollees will see lower prices this quarter for certain drugs treating cancer and genetic disorders under action unveiled by CMS.

Prescription Drug Pricing 122

Prescription Drug Pricing Medicare Medicare 122

Fierce Healthcare

JUNE 13, 2024

The Centers for Medicare & Medicaid Services (CMS) appears poised to rework Medicare Advantage (MA) quality ratings for this year, The Wall Street Journal

Medicare 126

Medicare Medicare Medicaid Medicaid 126

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 278

Fraud Medicare Medicare COVID-19 278

Healthcare Dive

JULY 28, 2023

A data breach earlier this year has affected tens of millions of individuals to date, and also compromised the sensitive personal and medical information of Medicare seniors.

Medicare 246

Medicare Medicare 246

Healthcare Dive

FEBRUARY 16, 2024

The latest audit from HHS’ Office of Inspector General comes as some Medicare flexibilities for telehealth are set to expire at the end of this year.

Medicare 173

Medicare Medicare 173

Healthcare Dive

AUGUST 24, 2023

The crackdown comes after media reports found fraudulent activity in hospice facilities, including those that certified patients for care who were not terminally ill and those that ran “churn and burn” Medicare billing schemes.

Medicare 246

Medicare Medicare 246

Fierce Healthcare

JUNE 17, 2024

Amazon Pharmacy is expanding its prescription drug subscription program, called RxPass, to Prime members on Medicare insurance. | The RxPass program, launched in January 2023, provides unlimited access to 60 eligible generic medications and will ship the medications to customers' homes for a flat monthly fee of $5.

Medicare 133

Medicare Medicare 133

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

NOVEMBER 9, 2023

New research from Harvard and Inovalon found MA beneficiaries had fewer hospital readmissions, fewer preventable hospitalizations and lower rates of high-risk medication use than those in traditional Medicare.

Health Outcomes 173

Health Outcomes Medicare Medicare Hospitals 173

Fierce Healthcare

APRIL 1, 2024

Insurers will feel resentful Monday as the feds opted to not reverse its decision to decrease Medicare Advantage benchmark payments by 0.16%, the Centers for Medicare and Medicaid announced. | CMS is not deviating from its January proposal to modestly rein in Medicare Advantage.

Medicare 143

Medicare Medicare Medicaid Medicaid 143

Fierce Healthcare

APRIL 30, 2024

CVS has quietly acquired Hella Health, a startup Medicare Advantage broker based in New York City, according to a post on LinkedIn. | CVS has quietly acquired Hella Health, a startup Medicare Advantage broker based in New York City, according to a post on LinkedIn.

Medicare 131

Medicare Medicare 131

American Medical Compliance

JULY 9, 2024

The Medicare FWA Compliance Training aims to educate healthcare providers (HCP) on the definitions of fraud, waste, and abuse in the context of Medicare. Additionally, education regarding Medicare FWA is crucial to providing proper care and the prevention of FWA. What Is Medicare?

Medicare 52

Medicare Medicare Compliance Fraud 52

Fierce Healthcare

JUNE 28, 2023

Medicare Advantage (MA) beneficiaries have fewer inpatient hospital stays and emergency department visits than beneficiaries in traditional fee-for-service Medicare, according to a

Medicare 120

Medicare Medicare Hospitals 120

Fierce Healthcare

MAY 6, 2024

The Hospital Insurance Trust Fund will be fully solvent for longer than previously projected, according to an annual Medicare Trustee report. | The Medicare Hospital Insurance Trust Fund won't run out of money as quickly as expected. Here's how federal officials are reacting.

Medicare 122

Medicare Medicare Hospitals 122

Fierce Healthcare

MAY 13, 2024

Online therapy provider Talkspace is making a big push into the Medicare market, rolling out to approximately 13 million members in 11 states. Talkspace plans to expand to all 33 million traditional Medicare members, coupled with several Medicare Advantage plans, across all 50 states by the end of the year.

Medicare 114

Medicare Medicare 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

Fierce Healthcare

MAY 9, 2024

Medicare Advantage plans have come under fire for upcoding that can increase the payouts they receive, and regulators point to health risk assessments as a likely culprit in this increase in coding | Medicare Advantage plans have come under fire for upcoding that can increase the payouts they receive, and regulators point to health risk assessments (..)

Medicare 119

Medicare Medicare 119

Healthcare Dive

MAY 3, 2023

Enrollment in MA plans has steadily increased since 2007, when one in five Medicare beneficiaries were enrolled in a private plan.

Medicare 229

Medicare Medicare 229

Fierce Healthcare

JANUARY 25, 2024

The Centers for Medicare & Medicaid Services is seeking feedback on how to increase transparency around Medicare Advantage and improve data capabilities. |

Medicare 128

Medicare Medicare Medicaid Medicaid 128

HealthIT Answers

OCTOBER 14, 2023

That’s why, 19 months from now, when I turn 65, I’m going to sign up for traditional Medicare. The post Medicare Advantage Bait and Switch appeared first on Health IT Answers. The only exception is anything really stupid that could kill me or you or both of us at the same time.

Medicare 111

Medicare Medicare 111

Fierce Healthcare

MARCH 15, 2024

Medicare households are spending far more on healthcare than other households, according to a new KFF analysis. Medicare households are spending far more on healthcare than other households, according to a new KFF analysis.

Medicare 124

Medicare Medicare 124

Fierce Healthcare

FEBRUARY 28, 2024

Walgreens will now accept a slew of Medicare Advantage supplemental benefits online, including the option for home delivery, the company announced this week. Walgreens will now accept a slew of Medicare Advantage supplemental benefits online, including the option for home delivery, the company announced this week.

Medicare 114

Medicare Medicare 114