On a Sunday afternoon during Florida’s Medicare open enrollment season, Janet Mills is deep into a twelve- or fourteen-hour day of volunteering as area director of the state's patient...
Recent guidance released by CMS is enabling the expansion of supplemental benefits in Medicare Advantage plans for contract year 2020, including adult day care services, according to a new study.
The...
CMS has announced the finalization of changes to the home health payment model, known as the home health prospective payment system (HH PPS), which includes a home infusion benefit and offers an...
An overwhelming 91 percent of payers think that alternative payment model (APM) activity will increase in the future, according to a recent survey conducted by Health Care Payment Learning and Action...
In a letter released on September 11, CMS informed UnitedHealthcare that its Medicare contract H5322 through Care Improvement Plus failed to meet its medical loss ratio requirement for the third year...
Employers are looking for broader provider networks, but healthcare payers who want to decrease the high cost-sharing must look for less expensive and fewer providers, a recent study by Kaiser Family...
Faced with a unique Medicare landscape going into 2020, Krista Bowers, general manager of senior markets at Blue Shield of California (BSC), and her team created a solution that no other company in the...
To resolve the lack of dental health plan coverage available for Medicare enrollees, the Kaiser Family Foundation (KFF) outlined five ways to improve seniors’ dental health plan...
The health insurance tax, mandated in the Affordable Care Act, will be back in effect in 2020 and is set to generate $15.5 billion in taxes due to CMS’s new 2020 payment rule.
“This new...
Medicare Advantage plans are not providing the same high-quality home healthcare to seniors that traditional Medicare does, Brown University researchers discovered.
According to the study, members of...
Contrary to the negative predictions, Medicare Advantage beneficiaries’ access to care and health plan affordability did not change between 2009 to 2017, according to a recent study published in...
The Office of Inspector General (OIG) audited Medicare spending and found that CMS spent $160.8 million paying for drugs that should have been covered by hospices. This data follows a 2012 OIG report...
CMS released a new Medicare Plan Finder that helps beneficiaries compare Medicare Advantage and Part D plans.
“The redesigned Medicare Plan Finder is another example of how CMS is empowering...
Thirty-nine percent of employers will be focusing more strategically on high-cost claims by 2020, according to a study by the National Business Group on Health (NBGH).
The NBGH study drew responses...
CMS finalized a decision to provide Medicare coverage for chimeric antigen receptor (CAR) T-cell therapy, which is an FDA-approved gene therapy used to treat non-Hodgkin lymphoma and B-cell precursor...
Expanding supplement benefits within the Medicare program could help underinsured seniors who see gaps in care now that they lack employer-sponsored plans, the Commonwealth Fund...
CMS Administrator Seema Verma declared Medicare Advantage the most successful result of Medicare and criticized the program’s other functions.
Verma also offered harsh words about proposals for...
Stockholders overwhelmingly approved the Centene-WellCare merger, the managed care company announced today.
“With the addition of WellCare, we are creating a combined company that is better able...
The healthcare payer and insurance industry are key drivers of state economies across the country, not only by expanding access to care and payer coverage, but by creating jobs for millions of...
Over half of dual-eligible Medicare Advantage beneficiaries experience the social determinants of health, revealing a need for better social health programming within the program, according to data...
