Medicare Advantage enrollment is on the rise across the United States, with more than 100 congressional districts boasting Medicare Advantage coverage of 50 percent or higher, according to an...
The US Department of Health and Human Services (HHS) and CMS announced that states will have another year to invest American Rescue Plan funds in home- and community-based services (HCBS).
“The...
CMS is considering using savings from low Medicare spending in Medicare Part B to offset beneficiaries’ 2023 Medicare Part B premiums.
The agency released a report examining whether CMS should...
Federal agencies and healthcare stakeholders have a renewed focus on addressing social determinants of health and health-related social needs as the COVID-19 pandemic highlighted the importance of...
Better Medicare Alliance (BMA) has endorsed HR 3173, the Improving Seniors’ Timely Access to Care Act, a law that seeks to reform prior authorization in Medicare Advantage.
“When it comes...
The National Quality Forum (NQF) has launched a comment period related to quality measures in federal programs.
“Conducting a thoughtful review of performance measures used in federal programs...
AHIP has expressed its support for a request from the US Department of Health and Human Services (HHS) and CMS to the Federal Communications Commission, which seeks confirmation of the agencies’...
CMS has updated its website, Medicare.gov, to include new features such as highlighting pages that answer popular questions and spotlighting key steps that consumers should take related to Medicare...
Medicare Advantage plans have incorrectly denied or delayed prior authorizations or payment requests and, in doing so, have accrued unwarranted revenues, according to a report from the Office of...
CMS and the Department of Health and Human Services (HHS) released the 2023 Notice of Benefits and Payment Parameters Final Rule, which includes standardized plan options, changes to network adequacy...
Payers, providers, and policymakers have taken a variety of approaches to social determinants of health data collection and interventions, according to an issue brief from Humana.
The brief provided...
CMS has released its strategy for health equity, which is the first pillar in the agency’s strategic vision.
“Advancing health equity is the core work of the Centers for Medicare &...
In the first quarter of 2022, payers witnessed significant changes in at-home coronavirus testing coverage with mixed reactions. These changes—and the influence of the coronavirus pandemic on preventive care—present both...
The CMS national coverage determination for the Alzheimer’s drug Aduhelm, or aducanumab, may fail to support health equity, as underrepresented populations may have limited access to clinical...
CMS has finalized its national coverage determination for monoclonal antibodies directed against amyloid, a new potential treatment for Alzheimer’s disease.
The agency moved forward with its...
Policymakers should consider increasing access to and promoting the use of biosimilars and monitoring trends in biosimilar coverage in order to bring down Medicare Part D spending, the Office of...
More than two-thirds of payers have published a patient access point in compliance with the Final Interoperability and Patient Access Rule, according to a study from the Council for Affordable Quality...
CMS announced an 8.5 percent boost on average to payer revenues next year in the 2023 Medicare Advantage and Part D Rate, according to a CMS press release.
This final rate announcement was higher than...
In a historic move, CMS has announced that Medicare Part B beneficiaries can receive full coverage for up to eight over-the-counter coronavirus tests in a calendar month during the coronavirus...
As the Affordable Care Act turns 12 years old, CMS and the Department of Health and Human Services (HHS) commemorate the law’s impact on the US healthcare system.
“On the...
