Fierce Healthcare

OCTOBER 13, 2023

Approximately 42% of Medicare Advantage plans that offer prescription drug coverage will have a star rating of four or more in 2024, marking yet another substantial decrease from

Medicare 126

Medicare Medicare 126

Fierce Healthcare

AUGUST 13, 2024

Fifty-four percent of Medicare beneficiaries are enrolled in a private Medicare Advantage plan, and in seven states that figure tops 60%, according to a new report from KFF.

Medicare 131

Medicare Medicare 131

Healthcare Dive

NOVEMBER 30, 2023

UnitedHealth’s MA growth could be depressed next year thanks to a rate notice from the CMS that’s deeply unpopular with insurers, management said during their investor day.

Medicare 293

Medicare Medicare 293

HealthIT Answers

AUGUST 29, 2023

By Chris Emper - On July 13, the Centers for Medicare & Medicaid Services released a 1,920-page proposed rule that would update payment policies and programs regarding Medicare payments to physicians and other providers under the Physician Fee Schedule on or after January 1, 2024.

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Medicare Medicare Medicaid Medicaid 111

Fierce Healthcare

SEPTEMBER 26, 2023

Expect premiums, benefits and plan choices for Medicare Advantage (MA) and the Medicare Part D prescription drug program to look similar in 2024, the Centers for Medicare & Medicaid Services (C | CMS announced that nearly three-quarters of MA plan beneficiaries will not see their premiums rise.

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Medicare Medicare Medicaid Medicaid 119

Fierce Healthcare

NOVEMBER 4, 2024

Days before the 2024 presidential election, the Centers for Medicare & Medicaid Services (CMS) released an unpublished version of the final calendar year 2025 physician fee schedule final rule | Digital therapeutics, telehealth, rural heath clinics and opioid treatment programs all got updates in the final 2025 Medicare physician fee schedule rule, (..)

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Medicare Medicare Medicaid Medicaid 127

Healthcare Dive

FEBRUARY 7, 2024

The insurer on Wednesday joined its peers in slamming proposed MA payment rates as insufficient given the dogged increase in medical costs.

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Medicare Medicare 276

Medisys Compliance

JULY 15, 2024

Introduction As an internal medicine practitioner, staying updated with the latest Medicare billing changes is crucial for maximizing reimbursements and ensuring compliance. In 2024, several significant updates have been introduced that directly impact the billing processes for internal medicine.

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Medicare Medicare Medical Billing Outsourcing COVID-19 59

Fierce Healthcare

JUNE 17, 2024

LAS VEGAS—The eyes of many regulators and lawmakers are on Medicare Advantage (MA), and, amid rising criticism of the program, one industry leader is making the case that "nostalgia" for traditiona | LAS VEGAS—The eyes of many regulators and lawmakers are on Medicare Advantage, and amid rising criticism of the program, one industry leader (..)

Medicare 111

Medicare Medicare 111

Med Law Blog

NOVEMBER 6, 2023

CMS issued the Final Rule for the 2024 Medicare Physician Fee Schedule (PFS) on November 2, 2023, for payments to be effective on or after January 1, 2024. Fee Schedule Link The overall payment rates under the PFS will be reduced by 1.25% in calendar year 2024.

Medicare 52

Medicare Medicare 52

Healthcare Dive

FEBRUARY 20, 2024

The big question coming out of the health insurance earnings season is how much elevated utilization among seniors will carry over into 2024.

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Medicare Medicare Health Insurance 306

Fierce Healthcare

SEPTEMBER 16, 2024

billion in Medicare Advantage quality bonus payments, according to a new analysis from KFF. Health plans are set to rake in $11.8

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Medicare Medicare 132

Healthcare Dive

JANUARY 8, 2024

The payer is taking issue with how regulators calculated quality scores for 2024, after seeing a stars decline that could cause its bonus revenue to fall by $500 million.

Medicare 286

Medicare Medicare 286

Fierce Healthcare

MARCH 4, 2024

Medicare Advantage (MA) growth has broadly slowed, but the biggest players in this space continue to claim the lion's share of this expansion, according to a new report from healthcare consultant C | Medicare Advantage growth has broadly slowed, but the biggest players in this space continue to claim the lion's share of this expansion, according (..)

Medicare 122

Medicare Medicare 122

Modern Healthcare

JULY 31, 2023

Skilled nursing faciltiies will receive a higher Medicare pay bump in fiscal 2024 than proposed by the Centers for Medicare and Medicaid Services in April.

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Nursing Homes Medicare Medicare Nurses 80

Healthcare Dive

JUNE 14, 2024

The redo comes after regulators lost two court cases over the methodology used to determine 2024’s quality ratings, and should result in hundreds of millions of dollars in additional bonuses to plans that see their ratings improve.

Medicare 266

Medicare Medicare 266

Med Law Blog

JULY 17, 2023

The 2024 Medicare Physician Fee Schedule proposes a 3.34% decrease in the 2024 PFS conversion factor. It’s currently $33.89 and is proposed to be reduced to $32.75.

Medicare 52

Medicare Medicare 52

Fierce Healthcare

MARCH 31, 2023

CMS to raise Medicare Advantage pay rates by 3.3% in 2024; phase in risk adjustment changes rking Fri, 03/31/2023 - 16:02

Medicare 135

Medicare Medicare 135

Fierce Healthcare

JUNE 4, 2024

SCAN Health Plan secured a court victory Monday when a federal judge agreed that the Centers for Medicare & Medicaid Services (CMS) inappropriately calculated its star ratings for the 2024 plan | SCAN Health Plan secured a court victory Monday when a federal judge agreed that the Centers for Medicare & Medicaid Services inappropriately calculated (..)

Medicare 119

Medicare Medicare Medicaid Medicaid 119

Fierce Healthcare

JUNE 3, 2024

Blue Cross and Blue Shield of Kansas City is leaving the Medicare Advantage (MA) market at the end of 2024, the insurer announced recently. Blue Cross and Blue Shield of Kansas City is opting out of the Medicare Advantage market.

Medicare 124

Medicare Medicare 124

HealthIT Answers

AUGUST 12, 2023

On August 1, 2023, the CMS issued the fiscal year 2024 Medicare hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. The final rule updates Medicare fee-for-service payment rates and policies for inpatient hospitals and LTCHs for FY 2024.

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Medicare Medicare Hospitals Payment Systems 52

Innovaare Compliance

DECEMBER 11, 2023

Before the Medicare Advantage Open Enrollment Period (MA OEP) [1] begins on January 1, 2024, Medicare Advantage Organizations (MAOs) still have time to review if they are completely ready for a new contract year. This blog article focuses on some of the “must make” changes to take effect as of January 1, 2024, or before.

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Medicare Medicare Compliance Medicaid 52

Med Law Blog

NOVEMBER 11, 2024

The final Medicare Physician Fee Schedule was issued on November 1 st for calendar year 2025. Attached is a link to both the Press Release describing all of the Medicare changes and the link to the entire Final Rule. The Medicare Conversion Factor for the Physician Fee Schedule was decreased from $33.29 from 2024 to $32.35

Medicare 40

Medicare Medicare 40

Healthcare IT Today

OCTOBER 19, 2024

John summarized a study in the American Journal of Managed Care highlighting how real-time interventional analytics reduced 30-day readmissions and Medicare spending per beneficiary for Penn Medicine affiliates. Read more… Healthcare IT Today Podcast : HLTH 2024 Conference Preview.

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Health Insurance Medicare Medicare Hospitals 113

Fierce Healthcare

FEBRUARY 1, 2023

CMS proposes small hike to Medicare Advantage, Part D plan payments in 2024 amid risk adjustment changes rking Wed, 02/01/2023 - 17:35

Medicare 111

Medicare Medicare 111

HealthIT Answers

MARCH 11, 2024

RISE National: Downtown Nashville, March 17-19, 2024. The trusted source for all things Medicare Advantage, crossing a variety of topics and themes from risk adjustment and quality to member experience and social determinants of health. The post RISE National 2024 appeared first on Health IT Answers.

Medicare 64

Medicare Medicare 64

Healthcare IT Today

OCTOBER 26, 2024

Read more… It’s Time to Combat “Instafraud” in Medicare Advantage. Read more… This Week’s Health IT Jobs for October 23, 2024: Multiple organizations with systems analyst roles to fill. In the wrong hands, LLMs can generate false or exaggerated medical documentation in an instant.

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Ransomware Fraud Licensing Nurses 114

Fierce Healthcare

OCTOBER 2, 2023

Independence Blue Cross unveiled Medicare Advantage (MA) packages that the company said will greatly enhance benefits for its MA members, including a bigger allowance for vision, dental, hearing an | The MA enhancements touted by Independence Blue Cross include reducing premiums for its Personal Choice 65 PPO while including a Part B giveback and a (..)

Medicare 111

Medicare Medicare 111

Fierce Healthcare

JANUARY 12, 2023

MedPAC calls for slight pay update to 2024 Medicare rates for hospitals, physicians. Thu, 01/12/2023 - 14:33.

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Medicare Medicare Hospitals 98

Fierce Healthcare

SEPTEMBER 29, 2023

The industry is just two weeks away from the beginning of Medicare's annual enrollment period, a critical window for the hottest market in insurance. | The industry is just two weeks away from the beginning of Medicare's annual enrollment period, a critical window for the hottest market in insurance.

Medicare 122

Medicare Medicare 122

Innovaare Compliance

OCTOBER 31, 2023

2024 Star Ratings , which CMS released on Oct 13 th , 2023, has forced the industry to deeply introspect and re-strategize the path forward with newer evaluation dynamics at play. More membership was distributed across lower Star ratings in 2024 compared to 2023. ” (replace life with Star ratings!)

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Medicare Medicare Compliance 52

Healthcare Law Blog

AUGUST 11, 2023

On July 13, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its proposed rule (the “Proposed Rule”) for the 2024 Medicare Physician Fee Schedule (“PFS”). CMS projects that the Proposed Rule will lead to growth in the Medicare Shared Savings Program (“MSSP”).

Medicare 52

Medicare Medicare Nurses Medicaid 52

Hall Render

DECEMBER 12, 2023

On November 16, 2023, the Centers for Medicare & Medicaid Services (“CMS”) published proposed changes to the Medicare provider enrollment requirements in the Calendar Year 2024 Physician Fee Schedule final rule (“Final Rule”).

Medicare 40

Medicare Medicare Licensing Malpractice 40

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

Fierce Healthcare

DECEMBER 18, 2023

Payers need to properly adapt to changes made to the Medicare Advantage star ratings program or risk financial repercussions, industry experts told Fierce Healthcare. Payers are being urged to prioritize health equity considerations more than ever before to improve their Medicare Advantage star ratings scores.

Medicare 119

Medicare Medicare 119

Health Care Law Brief

APRIL 3, 2023

On Friday, March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies ( Rate Announcement ). 1395w-23): Medicare Advantage Organizations (MAOs) are paid a base rate by CMS. Risk Adjustment.

Medicare 52

Medicare Medicare Overpayments Overpayment 52

Hall Render

NOVEMBER 29, 2023

On November 2, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued the 2024 Medicare Physician Fee Schedule Final Rule (“Final Rule”) for calendar year (“CY”) 2024. These changes become effective on January 1, 2024.

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Medicare Medicare Nurses Payment Systems 40