Fierce Healthcare

FEBRUARY 9, 2024

Though a spike in utilization among seniors slammed payers last year, particularly in the fourth quarter, each of the six major national firms turned a profit in 2023. Though a spike in utilization among seniors slammed payers last year, particularly in the fourth quarter, each of the six major national firms turned a profit in 2023.

Medicare 119

Medicare Medicare 119

HealthIT Answers

FEBRUARY 6, 2023

As you prepare to participate in this year’s Medicare Promoting Interoperability Program, CMS would like to highlight its requirements and share the program’s 2023 specification sheets. The post Medicare Promoting Interoperability Program 2023 Requirements appeared first on Health IT Answers.

Medicare 52

Medicare Medicare 52

Healthcare Dive

FEBRUARY 26, 2024

According to the Department of Justice, enforcement in Medicare Advantage is of “critical importance” as the number of beneficiaries in the privatized insurance program swells.

Medicare 264

Medicare Medicare 264

Fierce Healthcare

DECEMBER 29, 2023

Tech-enabled Medicare Advantage startup Devoted Health is closing out 2023 with $175 million in fresh funding, marking one of the largest funding rounds of the year. Tech-enabled Medicare Advantage startup Devoted Health is closing out 2023 with $175 million in fresh funding, marking one of the largest funding rounds of the year.

Medicare 130

Medicare Medicare 130

Healthcare Dive

JULY 14, 2022

Clover plans to offer Medicare Advantage plans in counties across Georgia, South Carolina and Tennessee next year, broadening its footprint to 220 counties in 2023.

Medicare 177

Medicare Medicare 177

Healthcare Dive

FEBRUARY 1, 2023

The payer said it expects to pick up 625,000 individual Medicare Advantage members in 2023.

Medicare 236

Medicare Medicare 236

Healthcare Dive

NOVEMBER 2, 2022

Executives said better benefits are attracting more members. For certain plans, Humana members have an allowance for healthy foods, over the counter items, transportation, health supplies, rent and utilities.

Medicare 243

Medicare Medicare 243

Healthcare Dive

APRIL 26, 2023

The insurer reported favorable MA inpatient utilization as COVID-19 claims decreased in the first quarter.

COVID-19 207

COVID-19 Medicare Medicare 207

Fierce Healthcare

NOVEMBER 20, 2023

Traditional Medicare paid out an estimated $31.2 billion in improper payments in fiscal year 2023, according to new data from the federal government. |

Medicare 131

Medicare Medicare Medicaid Medicaid 131

Fierce Healthcare

DECEMBER 21, 2023

Physician pay and workforce issues were top of mind for Fierce Healthcare readers in 2023. Physician pay and workforce issues were top of mind for Fierce Healthcare readers in 2023.

Medicare 122

Medicare Medicare Hospitals 122

Healthcare Dive

JANUARY 24, 2024

The health insurer’s stock plunged Thursday morning following its 2023 results, which fell startlingly short of Wall Street’s expectations.

Medicare 268

Medicare Medicare Health Insurance 268

HealthIT Answers

JULY 25, 2022

On July 15, 2022, CMS proposed Medicare payment rates for hospital outpatient and Ambulatory Surgical Center services. The calendar year 2023 Hospital Outpatient Prospective Payment System and ASC Payment System Proposed Rule is published annually and will have a 60-day comment period, which will end on September 13, 2022.

Payment Systems 52

Payment Systems Medicare Medicare Hospitals 52

Fierce Healthcare

DECEMBER 20, 2023

Among our most-read stories of the year, one topic clearly rose to the top: Medicare Advantage. Many of the most-read health insurance stories from Fierce Healthcare in 2023 center on Medicare Advantage.

Medicare 115

Medicare Medicare Health Insurance 115

Healthcare Dive

APRIL 5, 2022

CMS is not changing the risk adjustment calculation, which is meant to compensate plans for treating sicker patients. That's despite calls for an overhaul in the wake of allegations of abuse of the system.

Medicare 226

Medicare Medicare 226

Fierce Healthcare

JANUARY 14, 2022

MedPAC: Majority of Medicare beneficiaries to be on MA by 2023, but coding issues remain rampant. Fri, 01/14/2022 - 16:37.

Medicare 124

Medicare Medicare 124

Fierce Healthcare

SEPTEMBER 2, 2021

MedPAC considers one-time funding boosts for Medicare in 2023 due to COVID-19 confusion. Thu, 09/02/2021 - 17:11.

COVID-19 131

COVID-19 Medicare Medicare 131

Fierce Healthcare

APRIL 12, 2024

Any contentment about compensation gains was undercut by the effects of high inflation rates throughout 2023 and Medicare reimbursement cuts, according to Medscape's 2024 physician compensation report.

Medicare 132

Medicare Medicare 132

Healthcare Law Blog

JANUARY 10, 2022

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”). and 422.107).

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

HealthIT Answers

MAY 29, 2024

CMS announces that the Medicare Promoting Interoperability Program calendar year 2023 Hardship Exception application period is now open as of May 1, 2024. The post Medicare PI Program Hardship Exception Applications Are Now Open appeared first on Health IT Answers.

Medicare 59

Medicare Medicare Hospitals 59

Healthcare Dive

DECEMBER 4, 2023

The HHS’ Office of the Inspector General’s report tallied 707 criminal enforcement actions and 746 civil actions for fraud and misspent funds in programs like Medicare and Medicaid.

Fraud 245

Fraud Governance Medicaid Medicaid 245

Fierce Healthcare

NOVEMBER 11, 2024

Accountable care organizations in the ACO Reach program can claim credit for saving the Centers for Medicare & Medicaid Services (CMS) hundreds of millions of dollars | CMS released favorable savings results for ACO REACH Model participants, as industry group NAACOS begins to push for the program's extension through 2030.

Medicaid 111

Medicaid Medicaid Medicare Medicare 111

Healthcare Law Today

NOVEMBER 30, 2022

On November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) released its final 2023 Medicare Physician Fee Schedule (PFS) rule. Telehealth and other digital health modalities continue to increase in importance for Medicare populations and corresponding health care providers.

Medicare 132

Medicare Medicare Telemedicine Nurses 132

HealthIT Answers

FEBRUARY 9, 2024

Burda - The money flowing from Medicare into Medicare Advantage is like water gushing out of a frozen pipe. The post Medicare Advantage Is a Burst Pipe appeared first on Health IT Answers. By David R. Here are the latest numbers from CMS, which released its annual national health expenditure figures on Dec.

Medicare 59

Medicare Medicare 59

Med Law Blog

JULY 21, 2022

On July 7, 2022, CMS released its proposed Medicare Physician Fee Schedule for 2023, which proposes physician fee schedule reductions via the Medicare Conversion Factor. The general Medicare conversion factor will be reduced by 4.4% from $34,61 to $33.08. The anesthesia conversion factor will be reduced 3.9% from $21.56

Medicare 40

Medicare Medicare 40

Healthcare It News

DECEMBER 15, 2023

As swiftly moving AI technologies hold vast potential to improve healthcare delivery and outcomes, how we ensure their safe use in clinical care might just be the issue of the year for 2023, if not the decade.

Nurses 310

Nurses Medicare Medicare 310

Hall Render

JULY 28, 2023

Starting on August 1, 2023, Medicare validation edits will be activated to require service location addresses on the UB-04 hospital claim form to match exactly with the service location enrolled in Medicare’s Provider Enrollment, Chain, and Ownership System (“PECOS”). UB claim).

Medicare 40

Medicare Medicare Compliance COVID-19 40

Healthcare Law Today

NOVEMBER 29, 2022

On November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) finalized new policies related to remote therapeutic monitoring (RTM) services reimbursed under the Medicare program. The changes, part of the 2023 Physician Fee Schedule final rule , clarify CMS’ position on how it interprets requirements for RTM services.

Medicare 52

Medicare Medicare Telemedicine Nurses 52

Fierce Healthcare

FEBRUARY 15, 2023

Better Medicare Alliance launches bid to get rid of potential Medicare Advantage pay cut rking Wed, 02/15/2023 - 15:34

Medicare 98

Medicare Medicare 98

HIPAA Journal

APRIL 27, 2023

The Centers for Medicare & Medicaid Services (CMS) has started notifying certain Medicaid beneficiaries about an impermissible disclosure of some of their protected health information due to a mailing error at one of its contractors. The CMS believes that the risk of identity theft and Medicare fraud is minimal.

Medicare 108

Medicare Medicare Medicaid Medicaid 108

Health Law Advisor

MARCH 7, 2023

This feedback must be submitted to CMS by March 11, 2023 via email ( IRARebateandNegotiation@cms.hhs.gov ). Stakeholders can view CMS’s issuance of the Initial Inflation Rebate Guidances as an early step in the complex, multi-year process CMS must undertake to implement the various IRA provisions.

Medicare 52

Medicare Medicare Prescription Drug Pricing Medicaid 52

Compliance Now

SEPTEMBER 28, 2023

By Lee Spiegel , Compliance Director, MZQ Consulting By October 13, 2023, plan sponsors that offer prescription drug coverage must provide notices of creditable or non-creditable coverage to Medicare-eligible individuals. Have a deductible that is no more than $250/year.

Medicare 100

Medicare Medicare Medicaid Medicaid 100

Compliance Now

SEPTEMBER 28, 2023

By Lee Spiegel , Compliance Director, MZQ Consulting By October 13, 2023, plan sponsors that offer prescription drug coverage must provide notices of creditable or non-creditable coverage to Medicare-eligible individuals. Have a deductible that is no more than $250/year.

Medicare 100

Medicare Medicare Medicaid Medicaid 100

Healthcare IT News - Telehealth

JANUARY 23, 2023

As healthcare providers look ahead to 2023, being at the forefront of what's next in telehealth and strategically integrating the technology necessary to stay there may be critical to future success. You have identified three trends in telemedicine for 2023. Please elaborate. For example, the U.S. What do you see?

Telemedicine 208

Telemedicine COVID-19 Medicare Medicare 208

The Health Law Firm Blog

JUNE 14, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule [.] By George F. Indest III, J.D.,

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Med Law Blog

NOVEMBER 23, 2022

Please click the link to view the Medicare Physician Fee Schedule Final Rule Summary for 2023.

Medicare 52

Medicare Medicare 52

HIPAA Journal

JANUARY 31, 2024

Report: Security Breaches in Healthcare (Direct Download PDF, 1.9MB, 16 pages) An unwanted record was set in 2023 with 725 large security breaches in healthcare reported to the Department of Health and Human Services (HHS) Office for Civil Rights (OCR), beating the record of 720 healthcare security breaches set the previous year.

Ransomware 129

Ransomware HIPAA Hospitals Compliance 129

Fierce Healthcare

APRIL 24, 2023

Home care industry touts bipartisan bill to expand Medicare in-home benefits, reimbursement dmuoio Mon, 04/24/2023 - 14:08

Medicare 137

Medicare Medicare 137