Tag: Medicare Advantage plans

unitedhealthcare-loses-medicare-advantage-overpayment-suit.

UnitedHealthcare loses Medicare Advantage overpayment suit

Dive Brief: A federal appeals court has ruled against UnitedHealthcare, the biggest private payer in the U.S., and reversed a 2018 decision overturning Medicare’s overpayment rule requiring insurers to refund reimbursement to CMS within 60 days if they learn a diagnosis lacks medical record support. UnitedHealthcare argued in court in November the overpayment rule was […]
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Payer Moves to Increase Member Access to Acute Home Healthcare

Regence BlueShield’s new partnership will offer members access to quality acute home healthcare services. Regence BlueShield (Regence) has partnered with a home healthcare provider to increase member access to acute home healthcare services. Regence members in Pierce County, Washington will have access to the new program. The payer plans to expand the acute home healthcare […]
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Alignment Expands Medicare Advantage for Seniors in 3 States

The payer will debut its Medicare Advantage plans in select Arizona counties and expand coverage to additional counties in North Carolina and Nevada. Alignment Healthcare (Alignment) is extending its Medicare Advantage (MA) footprint in Arizona, North Carolina, and Nevada to provide coverage for more senior beneficiaries. Starting in 2022, Alignment will introduce its MA health […]
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Pros, Cons of Non-Emergency Medical Transportation Benefits

MACPAC’s June 2021 report to Congress included findings about non-emergency medical transportation benefits in Medicaid programs that could prove useful for benefits design. A small fraction of the Medicaid population utilizes non-emergency medical transportation (NEMT) benefits, but for that community of beneficiaries NEMT programs can be indispensable, a MACPAC report recently found. It has been […]
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Medicare Advantage Plans

Medicare Advantage Plans Could See Payments Drop in 2021 Due To Covid-19, Analysis Finds

  The COVID-19 outbreak appears to have impacted claims patterns for Medicare Advantage enrollees, according to a new analysis by Avalere Health. Even though seniors are historically the most vulnerable population health-wise, their claims were down dramatically during the month of April. The survey suggests it could impact risk score factors for MA plans in 2021, driving […]
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