The Centers for Medicare and Medicaid Services (CMS) has proposed new regulations requiring insurance agents and brokers to provide more detailed information to beneficiaries about Medicare Advantage plans.
Tag: Medicare
Thousands of Minnesotans Face Medicare Advantage Coverage Changes for 2025
The Medicare open enrollment period for 2025 ends on December 7, and Minnesota seniors enrolled in Medicare Advantage plans are facing significant disruptions to their healthcare options.
Highmark Partners With Senior Living Operators on Specialized Medicare Plan
Highmark Health’s subsidiary, Endorsed LLC, is teaming up with three senior living operators to offer a specialized Medicare Advantage plan aimed at dual-eligible seniors.
Insurers Face Challenges with Medicare’s Extra Payments for Home Visits
A recent report by The Wall Street Journal highlights that Medicare is issuing additional payments for home visits tied to patient diagnoses. This practice aims to incentivize thorough patient evaluations but has implications for insurers managing Medicare Advantage plans.
Report: U.S. Health Insurers Expected to Remain Resilient Amid Challenges in 2024
Capitalization levels for U.S. health insurers will continue to grow this year, but earnings are expected to narrow as profitability from government programs such as Medicaid managed care and Medicare Advantage return to more normal levels, according to a new AM Best report.
CMS Increasing Scrutiny of Nation’s Poorest-Performing Nursing Homes
The Centers for Medicare & Medicaid Services (CMS) is increasing scrutiny and oversight of the country’s worst-performing nursing facilities in an effort to improve the care they provide as soon as possible. CMS will toughen requirements for program completion and increase enforcement actions against facilities that fail to demonstrate improvement in a series of revisions… Continue reading CMS Increasing Scrutiny of Nation’s Poorest-Performing Nursing Homes
Big Pharma Looks to Ease Impact of Inflation Reduction Act
Drugmakers are attempting to limit Medicare’s newfound ability to negotiate drug prices while also dealing with internal industry disputes and dwindling influence in Washington, D.C. Congress granted Medicare, the country’s largest buyer of prescription drugs, the authority to negotiate how much it pays for certain high-priced therapies and to receive rebates on treatments whose prices… Continue reading Big Pharma Looks to Ease Impact of Inflation Reduction Act
Most of $9.2 Billion in Questionable Medicare Payments Went to 20 Insurers, Investigators Say
Medicare insurers drew $9.2 billion in federal payments in one year through controversial billing practices, with 20 companies benefiting disproportionately and together accounting for more than half of the total, according to federal health investigators. The findings by the Office of Inspector General of the Department of Health and Human Services are the latest sign… Continue reading Most of $9.2 Billion in Questionable Medicare Payments Went to 20 Insurers, Investigators Say
COVID Spurs Families to Shun Nursing Homes, Increasingly Choosing Home Care
The pandemic is reshaping the way Americans care for their elderly, prompting family decisions to avoid nursing homes and keep loved ones in their own homes for rehabilitation and other care. Americans have long relied on institutions to care for the frailest seniors. The U.S. has the largest number of nursing-home residents in the world.… Continue reading COVID Spurs Families to Shun Nursing Homes, Increasingly Choosing Home Care
For Many Pandemic Victims, Lingering Effects Stress Insurance Coverage
The new coronavirus that infected Tricia Sales in March still plagues her. The horse trainer and onetime cocktail server deals with dizziness and nausea. At times, she can’t feel her hands and feet. Her five-month struggle has meant specialists, drugs, a spinal tap, imaging scans and 15 hospital visits. The uninsured single mother said she… Continue reading For Many Pandemic Victims, Lingering Effects Stress Insurance Coverage