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Sep 4, 2024 | 
academic.oup.com | Medicare Advantage
Telehealth use increased markedly during the COVID-19 pandemic and continued at relatively high levels as the pandemic waned.1,2 Responding to the pandemic, the federal government relaxed rules for reimbursing telehealth visits for Medicare patients, and several states initiated similar action.
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Jun 10, 2024 | 
politicsdoneright.com | Joy-Ann Reid |Medicare Advantage |Byron Donalds
The time has come to declare Medicare Advantage a failed experiment. Are Democrats squandering 2024? Joy-Ann Reid schooled GOP Rep. Byron Donalds for his idiocy on Jim Crow. Podcasts (Video — Audio)Politics Done Right Live weekdays @ 3:00 PM CentralLive Calls: (281)823-7747A $600 Billion Swindle: Study Makes Case to ‘Abolish’ Medicare Advantage: “The time has come to declare MA a failed experiment,” write the authors of a new paper.
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Jun 7, 2024 | 
texashealthlaw.com | Medicare Advantage
Summary of article from Reuters, by Brendan Pierson:Humana can proceed with its lawsuit against a Biden administration rule that enables Medicare to reclaim overcharges from insurers. The rule, established in January 2023, permits the government to recoup payments to Medicare Advantage plans when audits reveal charges for diagnoses not present in patients’ medical records. The Biden administration believes this could help recover around $4.7 billion over a decade.
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May 13, 2024 | 
menafn.com | Medicare Advantage
Hospice Remains Underserved By Medicare Advantage, Data Shows
5/13/2024 2:11:32 PM
(MENAFN- Investor Brand Network) While the Medicare Advantage space grows bigger, it is difficult for regulators and the medical industry to decide how best to integrate hospice into MA programs. This is a major concern because hospice care is the only segment of the healthcare sector thatisn't catered for in Medicare Advantage (MA).
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Mar 13, 2024 | 
medcitynews.com | Marissa Plescia |Medicare Advantage
Quantum Health, a healthcare navigation company, has launched a navigation offering for Medicare Advantage plans, the company shared with MedCity News exclusively. Dublin, Ohio-based Quantum Health has traditionally served self-insured employers and helps connect employees with providers and digital health solutions. It supports 3.1 million members and nearly 500 employers.
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Jan 29, 2024 | 
texashealthlaw.com | Medicare Advantage
From Sheppard Mullin Richter & Hampton LLP, by Gianfranco Spinelli and Krysten Thomas:Final Rule Issued by CMS: The Centers for Medicare and Medicaid Services (CMS) issued a final rule titled “CMS Interoperability and Prior Authorization” on January 17, 2024, which aims to advance interoperability and improve prior authorization processes.
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Dec 25, 2023 | 
medcitynews.com | Marissa Plescia |Medicare Advantage
The healthcare landscape in 2024 presents some interesting challenges and opportunities, whether it’s in regards to generative AI or value-based care, according to executives at LRVHealth, a healthcare venture capital firm. These executives shared five predictions for 2024 with MedCity News: 1. Generative AI will become a reality: Generative AI will become more than “just hopes, dreams and pilot programs” in 2024, according to Keith Figlioli, managing partner at LRVHealth.
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Dec 11, 2023 | 
medcitynews.com | Marissa Plescia |Medicare Advantage
As scrutiny on Medicare Advantage grows, a bipartisan group of four senators sent a letter to the Centers for Medicare and Medicaid Services (CMS) last week asking the agency to collect and publish more data on MA plans. This includes data on prior authorization practices. The four senators that signed the letter were Elizabeth Warren (D-Massachusetts), Catherine Cortez Masto (D-Nevada), Bill Cassidy (R-Louisiana) and Marsha Blackburn (R-Tennessee).
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Nov 27, 2023 | 
medcitynews.com | Marissa Plescia |Medicare Advantage
Consumer / Employer, PayersSeniors are mostly still interested in $0 premium Medicare Advantage plans, according to a new eHealth report. However, slightly fewer seniors are choosing these plans compared to previous years. Seniors are largely interested in $0 premium Medicare Advantage plans, but demand is slightly lower than in previous years, a new report shows. About 83% of Medicare Advantage beneficiaries chose a $0 premium plan for coverage year 2024, according to eHealth’s November report.
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Nov 27, 2023 | 
texashealthlaw.com | Medicare Advantage
From HealthPayerIntelligence, Victoria Bailey:Cigna’s recent brush with False Claims Act violations serves as a reminder that Medicare Advantage organizations should be routinely assessing their risk and compliance activities. The United States alleged that Cigna submitted inaccurate and untruthful patient diagnosis data to receive additional payments from CMS and did not withdraw the inaccurate data or repay CMS.
