CMS reins in Medicare Advantage plansis a new online resource designed to meet the evolving needs of physicians. It brings together elements from Advanstar's trusted healthcare journals along with powerful tools, resources, decision support and advisory functions.Reid Paul...
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...
Medicare Advantage Plans Onerous Prior Authorizations Requirements & Negative Impacts on Skilled Nursing Facilities Stotler Hayes Group, LLCon2/17/2025 Traditional Medicare (Parts A and B) and Medicare Advantage (Part C, including additional vision, dental, and hearing benefits) plans aim to provide ...
(COVID-19). Medicare would cover 100% of the cost of COVID-19 vaccines approved by the Food and Drug Administration. There is no need to pay a deductible or coinsurance for vaccine administration. Medicare Part B, Medicare Part D, and Medicare Advantage plans all cover vaccines at no ...
CMS on Wednesday (Sept. 2) finalized plans to tie Medicare Advantage plans’ negotiated pay rates for hospital inpatient care to Medicare’s fee-for-service inpatient payment rates starting in fiscal 2024, though the agency backed off the idea of tying all third-party payer rates to what ...
“the plan name and address” of any identified Medicare Advantage or Part D plan. However, as noted, CMS also plans to provide thecontract number, contract name, plan number, and the plan’s COB address.See n. 1. Having this additional information may prove helpful in terms of ...
As Medicare Advantage premiums remain generally stable, more than 1,500 plans representing 8.7 million beneficiaries will participate in the CMS Innovation Center’s Medicare Advantage Value-Based Insurance Design (VBID) Model in 2024. The model improves access to supplemental benefits th...
plans to regularly review and mitigate the impact of biased data inputs. In addition, the proposed rule emphasizes that if MA plans utilize AI tools or automated systems, they must ensure that the usage of such tools complies with all existing Medicare policies ...
The federal government said it is giving Medicare Advantage plans the ability to require step therapy for Part B drugs, labeling it as a way to drive down drug costs by motivating pharmaceutical companies to come to the negotiating table. ...
For Medicare Advantage plans, the average monthly premium will decrease from $18.23 in 2024 to $17 in 2025, continuing a trend of declining premiums over recent years, said CMS. This reduction, the agency said, reflects not only its payment policy updates, but also the sustained competit...