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Latest News & Web Pages
Medicare Paid $12.3 Billion for These Services in 2024 & Now It's Limiting Coverage
9+ hour, 2+ min ago (307+ words) Medicare provides insurance coverage for many seniors 65 and over. Medicare paid billions to cover specific types of care for seniors in past years. New limits have now been imposed, making it harder to access 12 different medical services. Medicare provides essential…...
NIH grant funds evaluation of expanded Medicare Advantage benefits
16+ hour, 59+ min ago (289+ words) Today, more than half of older Americans receive their Medicare coverage through private Medicare Advantage plans. In 2020, that program made a sweeping policy shift, allowing those plans to offer supplemental benefits beyond traditional medical care, including groceries, meal deliveries, utilities,…...
Insurance Type and Medicaid Eligibility Linked to Gaps in Post-Stroke Care Quality
18+ hour, 13+ min ago (301+ words) University of Utah Health is the state's only academic health care system, providing leading-edge and compassionate care for a referral area that encompasses 10 percent of the US, including Idaho, Wyoming, Montana, and much of Nevada. A hub for health sciences…...
AHR Lauds Trilogy Gains, Medicare Advantage Rate Momentum for Nursing Homes During Leadership Transition
21+ hour, 34+ min ago (984+ words) geralt / Pixabay | CC0 American Healthcare REIT's (NYSE: AHR) strong fourth-quarter and full-year results were fueled largely by performance at its Trilogy assets. The portfolio also benefited from a more favorable payer mix, with growth in Medicare and Medicare Advantage and reduced…...
Medicare Advantage Star Ratings Explained
22+ hour, 28+ min ago (476+ words) Navigate today's economy with helpful tips + enter our $26K Sweepstakes! Ask AARP: AI-powered Tool to Get the Most Out of Medicare Events, News and Resources in Your State Starting with a look at how Star Ratings work today, this blog examines…...
Favorable OIG Advisory Opinion Underscores Ongoing Scrutiny of Ancillary Service Referrals
1+ day, 2+ hour ago (352+ words) The US Department of Health and Human Services Office of Inspector General (OIG) recently issued Advisory Opinion No. 26-02, concluding that a proposed arrangement under which an urgent care management entity would operate an affiliated clinical laboratory would not generate prohibited…...
To Avoid Care Disruptions, Know When the Clock Runs Out on Your Prior Authorization
1+ day, 6+ hour ago (1399+ words) A woman with multiple sclerosis wanted to be able to walk up the stairs at home without losing her balance. Her doctor prescribed medicine that helped, but then approval from her insurance plan for the drug expired. "Why do I…...
Governor sends letter to HHS requesting changes to Medicare Advantage rates
1+ day, 7+ hour ago (231+ words) Gov. Jenniffer Gonz'lez Col'n sent a letter this week to U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. in response to the notice of methodological changes for calendar year 2027 to Medicare Advantage capitation rates and payment policies for Parts…...
$3 million NIH grant funds national study of Medicare Advantage’s benefit expansion into social supports
1+ day, 17+ hour ago (277+ words) A $3 million National Institute on Aging grant will fund a national study of Medicare Advantage's benefit expansion into social supports such as food assistance, transportation, and other non-medical benefits." Led by George Mason University health economist Jeah Jung, the five-year…...
Kaiser’s $556 Million Medicare Advantage FCA Settlement: Implications for Providers and Plan Disputes
1+ day, 18+ hour ago (627+ words) Key Takeaways - DOJ's $556 million settlement with Kaiser Permanente shows intensified False Claims Act enforcement in Medicare Advantage risk-adjustment coding. Federal regulators continue to prioritize alleged upcoding and unsupported diagnosis submissions under Medicare Part C....By: Arnall Golden Gregory LLP Kaiser's $556 Million…...