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Monitor Improper Payments for Part C and Part D with Medicare Audit and Monitoring Software

Innovaare Compliance

The monthly premium for Medicare Part B rose 14.5%, from $148.50 By law, the Medicare Part B monthly premium must equal 25% of the estimated total Part B costs for enrollees age 65 and over. [1] By law, the Medicare Part B monthly premium must equal 25% of the estimated total Part B costs for enrollees age 65 and over. [1]

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Capitation Rates Announcement for CY 2025

Innovaare Compliance

The Centers for Medicare & Medicaid Services (CMS) officially announced capitation rates for Medicare Advantage (MA) plans for CY 2025 – average increase of 3.7% The base beneficiary premium (BBP) will be capped at 6% from prior year from 2024 to 2029 [3]. The cost to Medicare Part D would be $26.8 billion [4].

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Reduced Co-Insurance for Screening Colonoscopies

Medisys Compliance

For dates of service calendar years 2027-2029, the reduced coinsurance is 10%. For dates of service on or after calendar year 2030, Medicare waives the coinsurance. Background for Reduced Co-Insurance. These provisions are effective for services furnished on or after January 1, 2011.

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Rate Announcement for CY 2025

Innovaare Compliance

The Centers for Medicare & Medicaid Services (CMS) officially announced capitation rates for Medicare Advantage (MA) plans for CY 2025 – average increase of 3.7% The base beneficiary premium (BBP) will be capped at 6% from prior year from 2024 to 2029 [3]. The cost to Medicare Part D would be $26.8 billion [4].

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CMS Releases 2025 IPPS Final Rule

Hall Render

The Centers for Medicare & Medicaid Services (“CMS”) will publish the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) in the Federal Register on August 28 with an effective date of October 1, 2024. By FY 2027, these changes will increase IPPS spending by $459 million.

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Healthcare Reforms Under the IRA: Expanding Access to Care

Healthcare Law Blog

The expansive legislation includes key health care provisions, including drug pricing reforms, inflationary rebates, Medicare Part D benefit redesign, as well as myriad other updates. Medicare Drug Price Negotiation Program. The Inflation Reduction Act (“IRA”) was signed into law by President Biden on August 16, 2022.

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April-July 2022 State Regulatory Developments

New Jersey Healthcare Blog

New Expiration Date: March 8, 2029. The chapter describes the policies and procedures of the New Jersey Medicaid/NJ FamilyCare program regarding transportation services. Effective Date: March 14, 2022 until March 14, 2029. New Expiration Date: May 4, 2029. Effective Date: March 8, 2022. On April 4, 2022, at 54 N.J.R.