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 234

Medicare Medicare 234

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 281

Medicare Medicare 281

Fierce Healthcare

SEPTEMBER 20, 2023

Traditional Medicare not only doesn’t measure up to Medicare Advantage (MA) when it comes to cutting back on utilization, it also falls short in many ways compared to commercial insurance for those | Researchers say Medicare Advantage enrollees have more than 50% fewer inpatient hospital stays than FFS Medicare enrollees and 22% fewer visits to emergency (..)

Medicare 134

Medicare Medicare Hospitals 134

Fierce Healthcare

SEPTEMBER 19, 2023

The Centers for Medicare & Medicaid Services (CMS) finalized a rule Monday to streamline enrollment in Medicare Savings Programs (MSPs) with the aim of making coverage affordable for 860,000 mo | A $26.16 billion CMS rule will streamline Medicare Savings Program enrollment, reducing administrative burden in the process.

Medicare 119

Medicare Medicare Medicaid Medicaid 119

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 269

Medicare Medicare 269

Fierce Healthcare

SEPTEMBER 18, 2023

Seniors are becoming increasingly overburdened by marketing efforts from private Medicare plans, and low-income beneficiaries are twice as likely to file complaints regarding fraudulent phone calls | Fraudulent marketing practices are affecting low-income seniors looking for Medicare plans more than higher-income seniors, a new study has found.

Medicare 124

Medicare Medicare 124

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.

Medicare 283

Medicare Medicare Fraud Governance 283

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 124

Medicare Medicare Hospitals 124

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 105

Medicare Medicare Medicaid Medicaid 105

Healthcare It News

AUGUST 1, 2023

Patients are 50% more likely to get breast cancer screenings, and twice as likely to get colorectal cancer screenings, once they're in the Medicare program, according to new findings published by Epic Research.

Medicare 192

Medicare Medicare 192

Fierce Healthcare

SEPTEMBER 11, 2023

Members of MedPAC, the Medicare Payment Advisory Commission, reiterated their broad support for simplifying the Medicare Advantage (MA) landscape for consumers during a meeting Sept.

Medicare 115

Medicare Medicare 115

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.

Medicare 256

Medicare Medicare Fraud COVID-19 256

Fierce Healthcare

SEPTEMBER 14, 2023

A third set of Medicare Part B prescription drugs will cost up to $618 less per average dose beginning Oct. 1, announced the Centers for Medicare & Medicaid Services (CMS). |

Medicare 130

Medicare Medicare Medicaid Medicaid 130

Fierce Healthcare

SEPTEMBER 6, 2023

Research shows that Medicare spending has leveled off for the past decade, morphing from something that experts worried might break the federal budget to an unexpected bright spot. Medicare had once been seen as something that would one day break the budget. However, Medicare spending in the last decade slowed greatly.

Medicare 116

Medicare Medicare 116

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 290

Medicare Medicare 290

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 109

Medicare Medicare Medicaid Medicaid 109

Healthcare IT News - Telehealth

JUNE 19, 2023

Over the last few years, Medicare Advantage plans have dramatically increased their deployment of telehealth systems for seniors. While some in the healthcare industry may be skeptical of telehealth’s utilization, particularly within the Medicare population, these plans continue to move full steam ahead.

Medicare 148

Medicare Medicare Telemedicine Medicaid 148

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 278

Medicare Medicare Hospitals 278

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 240

Medicare Medicare 240

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 266

Medicare Medicare Hospitals 266

HealthIT Answers

AUGUST 28, 2023

CMS announced that the Medicare Shared Savings Program saved money for Medicare while continuing to support high-quality care. Specifically, the program saved Medicare $1.8 The post Medicare Shared Savings Program Saves Medicare More Than $1.8 billion in 2022 compared to spending targets for the year.

Medicare 52

Medicare Medicare 52

HIT Consultant

SEPTEMBER 12, 2023

The company plans to utilize the capital to support Bold’s continued expansion with national and regional Medicare plans and provider groups, and accelerate the growth of its clinical exercise offerings to support the diverse physical and mental health needs of older adults. The latest funding, bringing its total amount raised to $27M.

Medicare 116

Medicare Medicare 116

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 164

Medicare Medicare 164

Healthcare Dive

OCTOBER 31, 2022

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

Medicare 276

Medicare Medicare 276

Fierce Healthcare

SEPTEMBER 1, 2023

Humana has filed suit against the feds, saying the Biden administration's bid to claw back overpayments in Medicare Advantage (MA) is built on "shifting justifications and erroneous legal reasoning | Humana has filed suit against the feds, saying the Biden administration's bid to claw back overpayments in Medicare Advantage is built (..)

Medicare 101

Medicare Medicare Overpayments Overpayment 101

Fierce Healthcare

AUGUST 2, 2023

Medicare Advantage (MA) plans serve more marginalized and disadvantaged communities than fee-for-service (FFS) plans, according to a report from research firm ATI Advisory, building on previous res | New research gives greater insight into the differences between Medicare Advantage and fee-for-service beneficiaries.

Medicare 75

Medicare Medicare 75

Electronic Health Reporter

APRIL 27, 2023

Medicare is a federal health insurance program in the United States that provides coverage to people 65 or older and some younger people with specific disabilities. The program is divided into several parts, covering different […] The article What Do Medicare Parts A, B, C, D Mean? Illegal copying is prohibited.

Medicare 103

Medicare Medicare Health Insurance 103

Fierce Healthcare

JUNE 13, 2023

Legislators and policymakers have put payments to Medicare Advantage (MA) plans under the microscope, and new analysis highlights why. Legislators and policymakers have put payments to Medicare Advantage plans under the microscope, and new analysis highlights why.

Medicare 122

Medicare Medicare Overpayments Overpayment 122

Healthcare IT Today

FEBRUARY 22, 2023

There’s widespread consensus that payments to Medicare Advantage Organizations (MAOs) are a mess. These programs, which care for more than 30 million of the nearly 64 million Medicare enrollees , operate on the cutting edge of health care and suffer serious problems in data collection and billing.

Medicare 86

Medicare Medicare Doctors Overpayments 86

Fierce Healthcare

JULY 17, 2023

Alzheimer's disease drug Leqembi recently secured full approval from the Food and Drug Administration (FDA), and more expansive coverage from Medicare followed. | If projections are met, the new Alzheimer's drug meant to slow cognitive decline will cost Medicare more than $2 billion.

Medicare 98

Medicare Medicare FDA 98

Healthcare Law Blog

SEPTEMBER 28, 2023

The Centers for Medicare & Medicaid Services (“CMS”) released the final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”) on January 30, 2023. MAOs will be required to remit improper payments identified during RADV audits in a manner specified by CMS.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Fierce Healthcare

AUGUST 17, 2023

A recent survey from eHealth, an independent Medicare insurance adviser, released new data that shows 84% of respondents believe Medicare needs reform, but just 12% think changes should impact thei | A new survey shows that while seniors acknowledge Medicare reform is critical to the program's future, they expect to receive benefits at the cost (..)

Medicare 98

Medicare Medicare 98

Fierce Healthcare

JUNE 9, 2023

Emerging Alzheimer’s disease medications come with high price tags, but researchers with the University of Chicago calculate that in the long run, it’s much less costly to cover these therapies for | Emerging Alzheimer’s medications come with high price tags, but researchers with the University of Chicago calculate that in the long run, it’s much less (..)

Medicare 145

Medicare Medicare 145

Fierce Healthcare

JULY 26, 2023

Most Medicare Advantage (MA) enrollees use one or more supplemental benefits, with most health plan members using multiple benefits, according to a newly released report from the Elevance Health Pu | Extra benefits from Medicare Advantage plans are highly utilized by enrollees, which improves health outcomes among at-risk populations, new analysis (..)

Medicare 98

Medicare Medicare Health Outcomes 98

Fierce Healthcare

JULY 5, 2023

The quality bonus program (QBP) that rewards Medicare Advantage (MA) plans fails to achieve its two main goals: fairly rewarding MA insurers that actually improve quality and encouraging beneficiar | The Medicare Advantage Quality Bonus Program suffers from what some experts call the “Lake Wobegon Effect”: Too many plans are rated above average.

Medicare 111

Medicare Medicare 111

Fierce Healthcare

JUNE 27, 2023

Medicare Advantage (MA) beneficiaries given home-delivered meals in the four weeks after being discharged from a hospital were not only less likely to be readmitted within 30 days, they were also l | Kaiser Permanente Southern California found that a meal delivery program for Medicare Ad-vantage beneficiaries cut mortality rates, and improved outcomes (..)

Medicare 111

Medicare Medicare Hospitals 111

Fierce Healthcare

JULY 13, 2023

The Centers for Medicare & Medicaid Services (CMS) is recommending preexposure prophylaxis (PrEP) with oral or injectable antiretroviral therapy to people at risk of HIV without patient cost sh | A new proposal would allow Medicare beneficiaries to protect themselves against HIV without cost-sharing through preexposure prophylaxis and antiretroviral (..)

Medicare 98

Medicare Medicare Medicaid Medicaid 98