RAC Integration for Medicare Advantage Audits

Section 6411(b) of the Patient Protection and Affordable Care Act of 2010 (PPACA) requires the expansion of the Recovery Audit Contractor (RAC) program to Medicare Part C. While we may refer to either MA as Medicare Advantage (or a more accurate acronym, MAO, for Medicare Advantage Organizations), the simple fact is that the RACs (or Read more about RAC Integration for Medicare Advantage Audits[…]

Telehealth Expansion Proposed in Bipartisan Senate Bill

Earlier this month, a bipartisan group, led by U.S. Senator Brian Schatz (D-Hawaii), introduced a bill in the Senate focused on promoting cost savings and quality care under the Medicare program through the use of telehealth and remote patient monitoring (RPM) services, and incentivizing such digital health technologies by expanding coverage for them under the Read more about Telehealth Expansion Proposed in Bipartisan Senate Bill[…]

Medicare to cut payments to employer-sponsored Advantage plans

A new federal proposal would slash over payments made to Medicare Advantage plans sponsored by employers and unions years after an advisory board recommended the policy. The CMS proposed terminating the bidding process for employers and unions that offer 2017 Medicare Advantage plans to their retirees. The policy was included in the recent 228-page Medicare Read more about Medicare to cut payments to employer-sponsored Advantage plans[…]

Proposed Medicare loss is a gain for insurers

When is a loss a gain? It seems the answer is when the loss wasn’t nearly as bad as expected. That’s what major health insurers discovered when the Centers for Medicare and Medicaid Services proposed a slight decline in payments for Medicare Advantage plans. The proposal issued late last week to drop payments by 0.95%, Read more about Proposed Medicare loss is a gain for insurers[…]

HME News: CMS holds steady on Medicare Advantage

CMS has proposed a very small decrease in payments to Medicare Advantage plans for 2016, the agency announced Feb. 20. CMS says it wants to pay private insurers 0.95% less next year. When more intensive services are factored in, however, the agency says it expects overall payments to increase about 1.05%. “The proposed rates will Read more about HME News: CMS holds steady on Medicare Advantage[…]

Medicare Advantage funding could be cut

Supporters of Medicare Advantage program are roundly criticizing President Obama’s fiscal 2016 budget plan to slash more than $36 billion in its funding over the coming decade. In a Feb. 2 statement from the Better Medicare Alliance, interim executive director Krista Drobac said the cuts would only exacerbate the financial burden on enrollees who already Read more about Medicare Advantage funding could be cut[…]

Secretive Reviews Target 30 Medicare Advantage Plans

After years of criticism that they cost taxpayers too much, private Medicare Advantage health plans are facing landmark audits that for the first time could order them to repay the government tens of millions of dollars for past overcharges and other billing mistakes. Medicare pays the health plans a set amount monthly for each person Read more about Secretive Reviews Target 30 Medicare Advantage Plans[…]

Medicare Advantage plan sponsors weigh reimbursement increase

The region’s two biggest Medicare Advantage plan sponsors say they are reviewing government reimbursement rates for next year before making any decision about member benefits. The Centers for Medicare and Medicaid Services recently issued the fiscal 2015 rates for Medicare Advantage and prescription drug benefit programs that plan sponsors say are essentially flat when compared Read more about Medicare Advantage plan sponsors weigh reimbursement increase[…]