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Committee probes Medicare Advantage marketing tactics
Senate Finance Committee Chairman Ron Wyden, D-Ore., Jan. 23 asked five third-party marketing organizations that participate in Medicare Advantage enrollment to provide certain information by Jan. 31 about their business practices as the committee continues its inquiry into problematic MA marketing practices.
CMS seeks input to strengthen Medicare Advantage data, transparency
The Centers for Medicare & Medicaid Services seeks input through May 29 on ways to strengthen Medicare Advantage data to guide policymaking and advance transparency.
AHA proposes how Congress could truly reduce national health expenditures
In a statement submitted to the House Energy and Commerce Subcommittee on Health for a hearing Jan. 31 on national health expenditures, AHA urged the subcommittee to prevent certain Medicare Advantage plans from engaging in tactics that restrict and delay access to care while adding burden and cost to the health care system.
AHA podcast: The Effects of Medicare Advantage on Rural Hospitals With St. Bernards Healthcare
Chris Barber, president and CEO of St. Bernards Healthcare, discusses the problems certain MA plan practices can create for patients and their caregivers, especially for rural hospitals and health systems that face a unique set of challenges in caring for their communities.
CMS proposes Medicare Advantage, Part D payment changes for CY 2025
The Centers for Medicare & Medicaid Services will accept comments through March 1 at 6 p.m. ET on its advance notice of proposed changes to Medicare Advantage plan capitation rates and Part C and Part D payment policies for calendar year 2025, which the agency estimates will increase MA plan revenues by an average 3.70%.
CMS releases FAQs on 2024 Medicare Advantage rule
The Centers for Medicare & Medicaid Services yesterday released FAQs clarifying coverage criteria and utilization management requirements for Medicare Advantage plans under its final rule for calendar year 2024, which includes provisions intended to increase program oversight and create better alignment between MA and Traditional Medicare.
Survey: MA enrollees more likely to report care delays due to prior authorization
People enrolled in Medicare Advantage are more likely than those in traditional Medicare to report delays in care due to needed insurance approvals, according to a survey released Feb. 22 by the Commonwealth Fund, with 13% of traditional Medicare enrollees reporting associated delays compared with 22% of MA enrollees.
House passes spending package with certain health care provisions
The House March 6 voted 339-85 to pass a package of six appropriations bills that would fund certain federal agencies through fiscal year 2024 and contains certain health care provisions of interest to hospitals. The Senate is expected to consider the legislation later this week.
AHA files brief defending Louisiana 340B contract pharmacy law
AHA Feb. 29 filed a friend-of-the-court brief in support of a Louisiana law that prohibits drug companies from denying Louisiana hospitals the same 340B discounts for drugs dispensed at community pharmacies that would be provided via in-house pharmacies, its latest in a string of lawsuits claiming the federal law that created the 340B program preempts the state law.
AHA comments on Medicare outpatient observation status appeals rule
AHA Feb. 26 submitted comments on the Centers for Medicare & Medicaid Services’ proposed rule establishing appeals rights for Medicare beneficiaries admitted for an inpatient hospital stay subsequently reclassified to an outpatient stay with observation services.