4月4日,美国医保局(CMS)发布了2025年的Medicare Advantage和Medicare Part D的最终版规则,其中对生物类似药替代的要求明显降低,Medicare Part D的所有生物类似药替换不再明确要求CMS的提前批准,而此前这一原则仅适用于可互换的(interchangeable)生物类似药。 在此之前,任何生物药处方的变更中,CMS规定保险公司、PBM或...
Ahead of the Medicare Open Enrollment Period, CMS hasannouncedthat Medicare Advantage premiums, benefits, and plan choices will remain relatively stable in 2024. “A top priority for CMS is to protect and strengthen the Medicare program for people with Medicare, their children, and ...
Centers for Medicare & Medicaid Services's (CMS's) Medicare Advantage (MA) program conducted by the Government Accountability Office (GAO). It examined how CMS learned that private health insurer Humana Inc. sent a letter to beneficiaries on the impact of pending health reform legislation. The ...
Medicare Advantage (MA) organizations that use modern technology (such as artificial intelligence (AI)) to aid in making efficient coverage determinations are in the crosshairs of both Congress, which has held hearings and requested documents from MA organizations about AI and other ...
CMS估计,Medicare Advantage计划将使保险金平均下降1.91至30美元,PartD计划平均月保险金下降1.20至33.50美元。CMS预测,MedicareAdvantage计划的参保人数将上升9茗,达到2040万人,占医疗保险计划参保人数的34%。 【总页数】1页(P4-4) 【关键词】CMS;美国;医疗保险计划;参保人数;服务中心;医疗补助;费用信息;保险金 【...
Additionally, the administration changes in the upcoming year and potential CMS leadership by Dr. Mehmet Oz, an eager advocate of Medicare Advantage, add an element of uncertainty regarding the future development of this proposed rule. In particular, the Congressional Revi...
The lower MA premiums are expected to drive enrollment to 35.7 million by 2025 - about 51% of all Medicare beneficiaries.
CMS released its Advance Notice of Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies.
of health. Social determinants of health are the conditions in places where people live, learn, work and play that affect health risks and outcomes. The new definition opens the doors to coverage for new benefits for Medicare Advantage plans, which are projected to cover22.6 mil...
In this episode, AGG Healthcare attorneys Bill Dombi and Jason Bring discuss the hospice special focus program and CMS’ announcement that it will cease implementing the program in the face of litigation filed by providers and...more Medicare Advantage Plans Onerous Prior Authorizations Requirements ...