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News
An eye on major Medicare expansion
1+ week, 2+ day ago (829+ words) House Democrats don’t just plan to roll back President Donald Trump’s health care cuts should they win in November. They are also discussing a major expansion of Medicare coverage…...
At Senior Center | Getting ready for Medicare
4+ day, 23+ hour ago (26+ words) theorcasonian.com At Senior Center | Getting ready for...Medicare ||| FROM LENA KASSA for ORCAS SENIOR CENTER ||| About the Author: Community...
26 year old heart transplant survivor’s insurance denies vital drug, cost jumps from $180 to $1,000;
3+ week, 5+ day ago (708+ words) A 26-year-old heart transplant survivor was struggling to afford a medicine she needs to protect her...transplanted heart after her insurance company stopped covering it....Payton Herres had a heart transplant when she was a preteen....His heart was donated…...
s Wexner Medical Center and its cancer hospital go out of network for Humana Medicare Advantage patients
2+ week, 5+ day ago (248+ words) It covers the flagship Wexner Medical Center, the James Cancer Hospital and Solove Research Institute...The post Ohio State’s Wexner Medical Center and its cancer hospital go out of network for Humana Medicare...
‘Tsunami’ of Behavioral Health Challenges Amid OIG’s Anti-Psychotics Work Plan Seen Impacting QMs and Reimbursement in Nursing Homes
5+ day, 18+ hour ago (1207+ words) Meanwhile, the Centers for Medicare and Medicaid Services (CMS) has a schizophrenia audit focused on...other times it’s older residents with dementia that have behavioral symptoms or a patient with a substance...If a resident has a psychiatric condition, they…...
Humana CEO Visits Canal Pointe as Program Grows
3+ week, 36+ min ago (278+ words) NEW ORLEANS – Humana President and CEO Jim Rechtin visited Canal Pointe, New Orleans’ only family-centered...residential substance use treatment and recovery facility, on Aug. 20 to see the program supported by...parenting women to remain with their children while receiving…...
Providers warn of another decade of 340B payment problems
2+ week, 12+ hour ago (779+ words) In July, the Centers for Medicare and Medicaid Services proposed significantly cutting reimbursement...The problem at the center of the latest 340B debate is a policy that reduced reimbursement for 340B-acquired...The CMS had to unwind the payment reductions and make…...
10 SUD Providers Sue Cigna for $12.7M in Underpayments
2+ week, 6+ day ago (360+ words) Harbor Health, IMS Services, La Costa Recovery, San Diego Mental Health, Southern California Recovery Centers...“When insurance corporations underpay for mental health and substance use disorder services, the result...Harbor Health, IMS Services, La Costa Recovery, San Diego Mental Health,…...
JD Power Finds Medicare Advantage Satisfaction Drops as Members Demand Patient Advocacy
3+ week, 5+ day ago (278+ words) . - The largest two-year satisfaction declines centered on core consumer value metrics: Helping to Save...Medicare Advantage enrollees across 12 major U.S. market regions—evaluates plan performance across eight core...
Monogram Health to pay $2.4 million in Medicare Advantage false claims settlement
2+ week, 6+ day ago (283+ words) The categories cited were protein-calorie malnutrition, substance use disorder, coagulation defects and...Under Medicare Advantage, the Centers for Medicare & Medicaid Services pays private plans a fixed monthly...