Seniors to see reduced delays in Medicare coverage under new Biden admin policies

Healthcare Dive

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

How Modern Technology Revolutionizes Medicare Buying Process

Electronic Health Reporter

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.

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OIG report suggests telehealth fraud rare in Medicare

Healthcare Dive

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

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How To Market to Medicare Patients

Electronic Health Reporter

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.

Navigating The Modern Medicare-Digital Care Landscape

Electronic Health Reporter

The article Navigating The Modern Medicare-Digital Care Landscape appeared first on electronichealthreporter.com. Editorial Medicare coverage telehealthThis article is copyrighted strictly for Electronic Health Reporter. Illegal copying is prohibited. Telemedicine is rapidly defining the modern medical landscape, with thousands of patients moving away from in-person meetings to video consultation.

Supreme Court Rules Against HHS in Hospital Medicare Reimbursement Case

The Health Law Firm Blog

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.

Congress finally eliminates Part D vaccine cost sharing: Medicare coverage is still broken

Healthcare Dive

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

CMS redesigns controversial Medicare direct contracting model

Healthcare Dive

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

Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging

Kaiser Health News

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

Medical group asks Congress to offset Medicare payment cuts

Healthcare Dive

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

First-Ever Medicare Advantage Plan for LGBTQ+ Older Adults Launches

HIT Consultant

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 Shared Savings Program Saves Medicare More Than $1.6 Billion in 2021

HealthIT Answers

CMS announced that the Medicare Shared Savings Program, through its work with Accountable Care Organizations – groups of doctors, hospitals and other health care providers -- saved Medicare money while continuing to deliver high-quality care.

What You Need to Know about CMS’s 2023 Proposed Medicare Physician Payment Rule

HealthIT Answers

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 Advantage lobby rebuts senator’s inquiry into ‘potentially deceptive’ marketing tactics

Healthcare Dive

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’s Open Enrollment Is Open Season for Scammers

Kaiser Health News

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.

House progressive bill wants to take Medicare out of Medicare Advantage's name

Fierce Healthcare

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

How To Choose The Best Medicare Plan

Electronic Health Reporter

Medicare supplements in Florida are available from a wide list of providers. But how do you choose the best Medicare plan? Medicare Decisions Anyone who is interested in signing up for Medicare has many decisions […].

Hospitals charge employer health plans more than 2 times what they charge Medicare for same services

Healthcare Dive

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.

EasyHealth Secures $135M to Redesign Medicare Experience

HIT Consultant

What You Should Know: – Easyhealth raises $135M to redesign Medicare with its end-to-end Medicare experience to help 50 million Medicare members find the best plan and support them through their healthcare journey. Redesigning The Medicare Experience.

Senate passes bill extending ACA subsidies, adding Medicare price negotiations

Healthcare Dive

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

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2021 Medicare Advantage Plan Intelligence: An Early Look

Electronic Health Reporter

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.

Supreme Court rules in favor of HHS in Medicare disproportionate share payments case

Healthcare Dive

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

AHA urges DOJ to probe Medicare Advantage plans that deny care

Healthcare Dive

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

SCOTUS rejects UnitedHealth appeal of Medicare Advantage overpayment rule

Healthcare Dive

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

CMS calls for public input to improve Medicare Advantage

Healthcare Dive

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

Medicare Advantage premiums set to drop again next year

Healthcare Dive

Enrollment in the popular plans is expected to continue to grow in 2023, CMS predicts

Does Medicare Pay For Routine Vision Care?

Electronic Health Reporter

Medicare is a lifeline for millions of Americans, ensuring that they have access to all sorts of treatments, as well as things like prescription drugs and vital supplies to keep them healthy and happy. The article Does Medicare Pay For Routine Vision Care? Editorial Medicare vision care Part BThis article is copyrighted strictly for Electronic Health Reporter. Illegal copying is prohibited.

Digital Senior Care Navigator Fair Square Medicare Raises $15M 

HIT Consultant

What You Should Know: – Digital senior care navigator Fair Square Medicare raises 15M in series A funding led by Define Ventures. Launched in 2020 out of YC, Fair Square Medicare is a digital health platform company that’s revolutionizing how seniors navigate their healthcare.

Smaller rivals snap up Medicare Advantage members

Healthcare Dive

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

Doctor Indicted in $1.3 Million Medicare Fraud Kickback Case Seeks Reinstatement of Medicare Billing Privileges

The Health Law Firm Blog

million Medicare fraud scheme asked a New Jersey court to eliminate a bail condition. By George F. Indest III, J.D., M.P.A., Board Certified by The Florida Bar in Health Law On November 2, 2021, a doctor and his wife who had been indicted for their roles in a $1.3

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Medicare Advantage plans denied some members needed care, OIG finds

Healthcare Dive

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

Better Medicare Alliance: MA adds $32.5B in value to Medicare

Fierce Healthcare

Better Medicare Alliance: MA adds $32.5B in value to Medicare. rking. Thu, 10/21/2021 - 16:23

How Does Medicare Cover Telemedicine?

Electronic Health Reporter

Roberts, a Medicare insurance expert and co-founder, Boomer Benefits. The article How Does Medicare Cover Telemedicine? Roberts Medicare Part B outpatient coverage Part C Medicare Advantage plan Patient co-pays and co-insurance under Part B telehealth telemedicineThis content is copyrighted strictly for Electronic Health Reporter. By Danielle K.

Medicare Advantage plans make inflated dialysis payments, study says

Healthcare Dive

The study, published in Health Affairs, said large chains in the consolidated dialysis sector have the market power to negotiate higher MA reimbursement

Billing Medicare for ESRD Services

Medisys Compliance

Beneficiaries may become entitled to Medicare based on ESRD. Medicare Secondary Payer (MSP). Medicare is secondary to GHP coverage provided through the Consolidated Omnibus Budget Reconciliation Act (COBRA), or a retirement plan. Medicare Coverage for ESRD.

Medicare Physician Fee Schedule Final Rule Summary: CY 2023

Med Law Blog

Please click the link to view the Medicare Physician Fee Schedule Final Rule Summary for 2023. Articles Medicare & Reimbursement

House hearing ups ante on Medicare Advantage reform

Healthcare Dive

Lawmakers on both sides of the aisle are taking a harder look at coverage denials, fraud and waste in the popular MA program

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Understanding Basics of Medicare Overpayment

Medisys Compliance

What is Medicare Overpayment? A Medicare overpayment exceeds regulation and statute properly payable amounts. When Medicare identifies an overpayment, the amount becomes a debt a healthcare provider owes the federal government. Medicare Overpayment Collection Process.

Studies comparing Medicare Advantage, traditional Medicare don't capture enough racial, ethnic data: analysis

Fierce Healthcare

Studies comparing Medicare Advantage, traditional Medicare don't capture enough racial, ethnic data: analysis. fdiamond. Fri, 09/30/2022 - 09:54

CMS to ease Medicare ACOs into risk models in bid to boost participation

Healthcare Dive

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 data errors impede health equity efforts, OIG says

Healthcare Dive

The ability to assess health disparities and improve care delivery in communities of color hinges on the quality of race and ethnicity data that is currently falling short, the report said

Look Up Your Hospital: Is It Being Penalized By Medicare?

Kaiser Health News

For the readmission penalties , Medicare cuts as much as 3 percent for each patient, although the average is generally much lower. The patient safety penalties cost hospitals 1 percent of Medicare payments over the federal fiscal year, which runs from October through September.

Survey: Employers rein in health benefits for pre-Medicare and Medicare-eligible retirees

Fierce Healthcare

Survey: Employers rein in health benefits for pre-Medicare and Medicare-eligible retirees. fdiamond. Wed, 10/12/2022 - 15:37