Tag: Medicare Advantage

Is-Medicare-Advantage-Really-a-Disadvantage

Is Medicare Advantage Really a Disadvantage?

It’s autumn, and along with leaves changing color, pumpkin spice lattes, and cooler weather comes an avalanche of TV ads, commercials, and telephone marketing calls, all entreating us to believe that Medicare Advantage (MA) is the best thing since the invention of the cell phone. With open enrolment season upon us, it’s critical to examine […]
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Five Key Priorities Expected to Drive CMS Health Equity

Five priorities are identified in the mission of CMS Office of Minority Health, “Working to Achieve Health Equity.” The Centers for Medicare & Medicaid Services (CMS) has five key priority areas that are expected to drive how the agency will, within a span of 10 years, accomplish its stated goal to achieve health equity. Priority […]
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Prior Authorization Reform in Medicare Advantage | Case Studies | AllZone Management Services Inc.

Prior Authorization Reform in Medicare Advantage

Prior Authorization reform in Medicare Advantage would help relieve administrative burden for medical groups and reduce patient care delays, MGMA said. The Medical Group Management Association (MGMA) has urged CMS to implement policies that support prior authorization reform and value-based care contracts within the Medicare Advantage program. MGMA submitted comments to CMS Administrator in response […]
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BMA Supports Bill on Medicare Advantage Prior Authorizations

The bill would aim to standardize processes and require greater oversight on Medicare Advantage plans’ utilization and denial of prior authorizations. Better Medicare Alliance (BMA) has endorsed HR 3173, the Improving Seniors’ Timely Access to Care Act, a law that seeks to reform prior authorization in Medicare Advantage. “When it comes to the use of […]
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cms-issues-contract-year-2023

CMS Issues Contract Year 2023 Final Rule for Medicare Advantage Organizations and Prescription Drug Sponsors

  On April 29, 2022, the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”).  CMS promotes the Final Rule as advancing “CMS’ strategic vision of expanding access to affordable health care […]
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CMS Issues IPPS and LTCH Proposed Rule for FY 2023

CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System Proposed Rule for FY 2023 (the Proposed Rule). In the Proposed Rule, CMS proposes to update the IPPS and LTCH payment rates, modify the payment rules for direct graduate medical education (DGME) to comply with a recent […]
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cms-aims-eliminate-delays-new-medicare-coverage-and-expand-special-enrollment-periods

CMS aims to eliminate delays in new Medicare coverage, expand special enrollment periods

The Biden administration wants to close the gap before new Medicare beneficiaries can get coverage and expand use of special enrollment periods. The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule Friday that updated Medicare enrollment and eligibility rules. One of the key proposals is to provide Medicare coverage a month immediately […]
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Key Advantages of Medicare Advantage Plans Versus FFS Medicare

Medicare Advantage plans draw a more diverse beneficiary population and can result in lower healthcare spending for low-income beneficiaries. Medicare Advantage plans may provide better access to care and lower healthcare spending for enrollees, compared to fee-for-service Medicare, according to a study from ATI Advisory conducted on behalf of Better Medicare Alliance (BMA). “Medicare Advantage […]
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AHA Asks CMS to Waive Medicare Advantage Prior Authorization During PHE

CMS encouraged Medicare Advantage plans to waive prior authorizations during the public health emergency, but AHA urged the agency to make it a requirement instead of a suggestion. The American Hospital Association (AHA) has asked CMS to work with Congress and require Medicare Advantage plans to waive prior authorization processes during the current and future […]
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medicare-advantage-plans-boost-supplemental-benefits-offerings

Medicare Advantage Plans Boost Supplemental Benefits Offerings

Medicare Advantage plans expanded their supplemental benefits offerings in 2022, with more health plans offering special supplemental benefits for the chronically ill (SSBCI), according to an issue brief commissioned by Better Medicare Alliance. Medicare beneficiaries typically join Medicare Advantage plans because of the array of supplemental benefits that the program offers in addition to traditional […]
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