“With so many Medicare Advantage options to choose from, it’s crucial for seniors to have access to high quality, data-driven resources as they make their health care decisions,” said Sumita Singh, senior vice president and general manager of health at U.S. News, in a press release....
Medicare Advantage Has Become Notorious for Prior Authorization—CMS and Lawmakers Are Taking Actiondoi:10.1001/jama.2024.13383MEDICARE Part CLEGISLATORSThis Medical News article discusses care denials under Medicare Advantage plans and efforts to streamline the prior authorization process.Cahan, E...
(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 algorithm use, and members who have filed class action lawsuits alleging certain MA organizations ...
Medicare Advantage, or Medicare Part C, is a private insurance alternative to traditional Medicare. Many, or all, of the products featured on this page are from our advertising partners who compensate us when you take certain actions on our website or click to take an action on their website...
Scammers inform you of a refund owed to you because of changes to Medicare or from private insurance companies. They may say the refund is part of a class action lawsuit. Naturally, the caller needs to know your Social Security Number and bank account information. This is a popular scam, ...
Those reforms won’t eliminate waste, fraud, and abuse, but the structural reforms will make it harder for crooks to take advantage of the programs. P.S. If you want more background information on Medicare, here’s a post that explains why the program is so costly even though seniors don...
The article reports on the impact of the proposed cuts on the Medicare Advantage (MA) fund in the health sector of Puerto Rico. It mentions that specialists and hospitals will experience a reduction of their fees and demand for services while a lot of people will loss their jobs and a numb...
The Centers for Medicare & Medicaid Services is seeking feedback on how to increase transparency around Medicare Advantage and improve data capabilities. Therequest for information(PDF) is the latest MA-focused action the agency has taken this month. Last week, the agency finalized a rule that gi...
2. Medicare Part D and Medicare Advantage Medicare Advantage, sometimes called Medicare Part C, is a bundled alternative to Original Medicare and is sold by private health insurance companies. Medicare Advantage plans cover all of the benefits of Part A and Part B, and most of them also includ...
Remember to mark your calendar and take action during the AEP to ensure you have coverage that best matches your needs. Making changes during this period allows you to secure new coverage for the upcoming year and potentially take advantage of cost savings, expanded benefits or better-suited plan...