Fierce Healthcare

MARCH 4, 2024

Medicare Advantage (MA) growth has broadly slowed, but the biggest players in this space continue to claim the lion's share of this expansion, according to a new report from healthcare consultant C | Medicare Advantage growth has broadly slowed, but the biggest players in this space continue to claim the lion's share of this expansion, according (..)

Medicare 301

Medicare Healthcare 301

Fierce Healthcare

JANUARY 12, 2024

A MedPAC meeting on the status of Medicare Advantage held Friday began with numbers on enrollment and insights into coding diagnoses, before devolving into contentious debate over the quality of th | Spirited disagreement arose during MedPAC's Medicare Advantage sessions on Friday, as members debated the merits of the program.

Medicare 307

Medicare 307

Fierce Healthcare

APRIL 3, 2024

To address the nation’s drug shortages, the Department of Health and Human Services (HHS) is floating a plan that would attach new Medicare payments and penalties to hospitals’ supply chain practic | A white paper penned by HHS outlines a potential program that would push hospitals toward inventory and purchasing practices that reinforce long-term (..)

Medicare 291

Medicare Hospitals 291

Health Care Dive

FEBRUARY 2, 2024

The health insurer sees Medicare Advantage as an area for future growth, despite selling the division for $3.7 billion earlier this week. Cigna’s CEO called the sale a “win-win” on a call with investors Friday.

Medicare 276

Medicare 276

Fierce Healthcare

MARCH 5, 2024

A new-look Medicare Advantage (MA) quality bonus program would better incentivize insurers and help individuals choose a more appropriate plan, a report from Urban Institute finds. | A new report looks at how the Medicare Advantage quality bonus program could be improved, including taking the star ratings reporting private.

Medicare 242

Medicare 242

Fierce Healthcare

OCTOBER 18, 2023

Seniors are forced to navigate a convoluted Medicare Advantage (MA) landscape for healthcare coverage, often only to be denied care, experts told legislators during a Senate Finance Committee heari | Senators and experts agreed Wednesday that marketing practices from Medicare Advantage plans are often overwhelming for seniors.

Medicare 347

Medicare Healthcare 347

Fierce Healthcare

JANUARY 31, 2024

Medicare Advantage (MA) payments are set to decrease yet again in 2025 as the feds phase in significant changes to risk adjustment. Medicare Advantage payments are set to decrease yet again in 2025 as the feds phase in significant changes to risk adjustment.

Medicare 307

Medicare 307

Fierce Healthcare

MARCH 15, 2024

Providers objected to its proposal to give physician reimbursement relief, while plans disagreed with its attitude toward Medicare Advantage. Health plans and providers alike are disgruntled with a new report (PDF) to Congress released | It seems everyone was left unsatisfied by MedPAC's newest report to Congress.

Medicare 334

Medicare 334

Fierce Healthcare

OCTOBER 9, 2023

LAS VEGAS—Medicare Advantage (MA) has only grown over the last decade, and, in tandem, voices criticizing the program have gotten louder. | LAS VEGAS—Medicare Advantage has only grown over the last decade, and, in tandem, voices criticizing the program have gotten louder.

Medicare 350

Medicare 350

Fierce Healthcare

JANUARY 31, 2024

Cigna will sell off its Medicare business to Health Care Service Corporation in a deal valued at $3.7 HCSC will acquire Cigna's Medicare Advantage, Part D, supplemental benefits and CareAllies businesses, and the parties expect the deal to close in the first quarter of 2025. billion, the company announced Wednesday.

Medicare 307

Medicare 307

Fierce Healthcare

NOVEMBER 6, 2023

Cigna is looking into the possibility of selling its Medicare Advantage (MA) business, according to a report from Reuters. Cigna may decide to sell off its Medicare Advantage business. The insurer is reportedly in early discussions with an investment bank to go over its options.

Medicare 293

Medicare 293

Fierce Healthcare

FEBRUARY 9, 2024

A bipartisan group of senators announced Friday that they are working on new legislation for “long-term reforms” to physician payments under Medicare and other program changes. | The lawmakers plan to investigate and pass "long-term reforms" that will "ensure financial stability for providers," among other goals.

Medicare 322

Medicare 322

Fierce Healthcare

JANUARY 29, 2024

Medicare Advantage (MA) continues to grow, but there are signs that its profitability is on the decline, according to a new report from Moody's Investors Service. Medicare Advantage continues to grow, but there are signs that its profitability is on the decline, according to a new report from Moody's Investors Service.

Medicare 284

Medicare 284

Fierce Healthcare

NOVEMBER 20, 2023

Traditional Medicare paid out an estimated $31.2 The Centers for Medicare & Medicaid Services released its annual look at improper payments and found that the overall rate in Medicare was 7.38%, which sits below the 10% level mandated in statute.

Medicare 326

Medicare Medicaid 326

Fierce Healthcare

FEBRUARY 15, 2024

Seven durable medical equipment companies cost the Medicare system $2 billion in payments, the National Association of ACOs (NAACOS) told the federal government in recent months. ACOs could face lasting financial difficulties because of a recent, alleged $2 billion Medicare catheter fraud scheme.

Medicare 317

Medicare 317

Fierce Healthcare

FEBRUARY 23, 2024

Just a few short months after making a push into the payer space, digital health company Waltz Health is stepping into the Medicare market. Just a few short months after making a push into the payer space, digital health company Waltz Health is stepping into the Medicare market.

Medicare 256

Medicare 256

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 293

Medicare Medicaid 293

Fierce Healthcare

OCTOBER 16, 2023

A research brief out of think tank Urban Institute evaluates the prospect of reducing Medicare spending by reining in excessive post-acute care rates. | New research shows that MedPAC's previous proposal for a unified payment structure for post-acute care could save Medicare billions.

Medicare 313

Medicare 313

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 307

Medicare 307

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 335

Medicare Hospitals 335

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 284

Medicare 284

Fierce Healthcare

NOVEMBER 21, 2023

A City of Hope analysis found that Medicare Advantage members faced a delay of two weeks or more between diagnosis and their first course of therapy.

Medicare 313

Medicare 313

Fierce Healthcare

DECEMBER 15, 2023

While its merger with Humana may have fallen through for now, Cigna is attracting plenty of interest for the rumored sale of its Medicare Advantage business, Bloomberg reported.

Medicare 299

Medicare 299

Health Care 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 252

Medicare 252

Fierce Healthcare

OCTOBER 27, 2023

The Department of Justice (DOJ) has filed charges against a former HealthSun Health Plans executive as part of an alleged multimillion-dollar Medicare fraud scheme. | The Department of Justice has filed charges against a former HealthSun Health Plans executive as part of an alleged multimillion-dollar Medicare fraud scheme.

Medicare 318

Medicare 318

Health Care 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 295

Medicare 295

Fierce Healthcare

FEBRUARY 23, 2024

The agency said it is still litigating Medicare Advantage cases against major insurers. Under the False Claims Act, more than $1.8 billion last year, according to the Department of Justice.

Medicare 301

Medicare 301

Health Care 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 321

Medicare Regulations 321

Fierce Healthcare

OCTOBER 13, 2023

Approximately 42% of Medicare Advantage plans that offer prescription drug coverage will have a star rating of four or more in 2024, marking yet another substantial decrease from

Medicare 313

Medicare 313

Health Care Dive

JANUARY 16, 2024

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

Medicare 333

Medicare 333

Fierce Healthcare

NOVEMBER 15, 2023

UnitedHealthcare is facing a potential class action lawsuit following allegations that it used an algorithm to deny claims for post-acute care services in Medicare Advantage.

Medicare 355

Medicare 355

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 322

Medicare Medicaid 322

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 293

Medicare Medicaid 293

Fierce Healthcare

OCTOBER 4, 2023

Mental health provider Brightside Health is partnering with Centene, Optum, Lucet, Blue Cross and Blue Shield of Texas and other payers to serve 50 million people in Medicare and Medicaid. Brightside Health announced expanded partnerships with major health payers including Centene, Optum and Lucet on Thursday.

Medicaid 291

Medicaid Medicare 291

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 284

Medicare 284

Fierce Healthcare

FEBRUARY 20, 2024

Mental health provider Brightside Health bolstered its partnerships with Medicare, Medicaid and Medicare Advantage contracts throughout the country. Brightside Health has announced new payer partnerships with major plans to provide members with mental health care.

Medicare 167

Medicare Medicaid 167

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 300

Medicare 300