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CMS to get ‘tougher’ on Medicare Advantage, official promises

Health Care Dive

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 322
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Lobby-funded study argues Medicare Advantage rate cuts are worse than CMS expects

Health Care Dive

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 274
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CMS finalizes 2024 Medicare hospital, doctor payments, 340B fix and price transparency requirements

Health Care Dive

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 305
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Elevance sues HHS over Medicare Advantage star ratings

Health Care Dive

The payer is taking issue with how regulators calculated quality scores for 2024, after seeing a stars decline that could cause its bonus revenue to fall by $500 million.

Medicare 293
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Private equity deals in MA are declining, but experts say regulators should keep an eye on this space

Fierce Healthcare

Private equity firms have seen plenty of potential in the rapidly growing Medicare Advantage space, but deal volumes are slowing, according to a new report. Private equity firms have seen plenty of potential in the rapidly growing Medicare Advantage space, but deal volumes are slowing, according to a new report.

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OIG report suggests telehealth fraud rare in Medicare

Health Care 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.

Medicare 274
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Private equity deals in Medicare Advantage decline, report finds

Health Care Dive

High interest rates and new regulations could be driving the slowdown, according to a report by the Private Equity Stakeholder Project.

Medicare 283