Tag: Medicare Beneficiaries

Medicare, Beneficiaries Saw Higher Prices at Provider-Based Facilities

Medicare, Beneficiaries Saw Higher Prices at Provider-Based Facilities

The Medicare program and Medicare beneficiaries could have saved a combined $1.6 billion if provider-based facilities charged the same payment rate as freestanding facilities, OIG found. Medicare and its beneficiaries paid significantly higher prices at provider-based facilities than they would have paid to freestanding facilities for the same services, according to a report from the […]
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CMS aims to eliminate delays in new Medicare coverage, 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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Medicare Patients Received 54.5M Office Visits Via Telehealth in 2020

Medicare Patients Received 54.5M Office Visits Via Telehealth in 2020

Office visits represented 48 percent of all telehealth services used in the first year of the pandemic, making it the service most accessed via telehealth, federal data shows. Medicare beneficiaries most often used telehealth for office visits in 2020, receiving 54.5 million virtual office visits in the first year of the COVID-19 pandemic, according to […]
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More Medicare Advantage plans will offer nonmedical benefits in 2022, finds Avalere

More Medicare Advantage plans will offer nonmedical benefits in 2022, finds Avalere

  More plans will offer meals, nutrition, transportation or in-home support services at a $0 premium in 2022. Ahead of the annual election period, which began on October 15, the Centers for Medicare and Medicaid Services published information on MA and Part D plan (PDP) premiums, benefit offerings and star ratings. Avalere analyzed that data […]
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Most Medicare beneficiaries don’t compare coverage options during open enrollment

Most Medicare beneficiaries don’t compare coverage options during open enrollment

Since not shopping around can have an impact on enrollees’ coverage and costs, CMS recommends they review and compare plans each year. The numbers are similar across both Medicare Advantage and traditional Medicare, with 68% of MA beneficiaries saying they don’t compare medical plans, and 73% of those in traditional Medicare claiming the same. The […]
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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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New Medicare Rule Will Cut Payments to Hospitals for Some Surgeries

New Medicare Rule Will Cut Payments to Hospitals for Some Surgeries

A cost-cutting change in Medicare policy will reduce payments to hospitals for some surgical procedures and increase costs for patients, according to a March 21 report from the The Washington Post. Before the change, CMS categorized 1,740 surgeries and other services as eligible for Medicare payments only if they were performed on beneficiaries who were admitted […]
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CMS Accelerates Medicare Beneficiaries’ Access to Innovations

CMS Accelerates Medicare Beneficiaries’ Access to Innovations

Medicare beneficiaries now have immediate access to innovative medical technology approved by the U.S. Food and Drug Administration (FDA), rather than having to wait for it to clear additional bureaucratic hurdles before coverage is approved. The Medicare Coverage of Innovative Technology (MCIT) final rule issued this week eliminates the time and cost innovators were formerly […]
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