dropped to 3.5 from 4.5. Star ratings are crucial for health insurers as they reflect the quality of the insurance plans. The dip in this contract’s rating will likely impact the company’s quality bonus payments in 2026.
Prepay claims editing improves payment accuracy for self-funded employers Learn how Cotiviti helped one benefit administrator prevent $28M in inappropriate payments for clients. Read Case Study Talk with an expert Learn more about how our solutions can help you meet your goals Contact us Payme...
作者: Centers for Medicare & Medicaid Services, or CMS, released the Calendar Year 2026 Advance Notice for the Medicare Advantage, or MA, and the Medicare Part D Prescription Drug Programs that would update payment policies for these programs. Payments from the Government to Medicare Advantage plan...
The Initial Guidance outlined the Exception for Small Biotech Drugs, which allows drugs that constitute a small percentage of CMS’s expenditures, but a large percentage of CMS’s total payments to the drug’s manufacturer, to be exempt from the price negotiation process. This process remains lar...
More than half of people on Medicare, the program for older adults and people with disabilities, are now enrolled in Medicare Advantage plans, but government watchdogs and others consistently find that they deny necessary care and collect billions in dubious payments every year. The plan rolle...
Housing accounts for more than a third of many seniors’ spending. Here’s how to save. Maryalene LaPonsieJan. 21, 2025 Reduce Your Housing Costs in Retirement Here's what to consider when taking unemployment benefits and Social Security payments at the same time. Rachel HartmanJan. 21, ...
That’s because government payers rely on lower payments to hospitals and doctors to keep costs in check. Look no further than Medicare. The American Hospital Association says that hospitals receive just 87 cents for every dollar they spend treating Medicare beneficiaries. That’s obviously not ...
monetizing actionable information learned during the sales process (like drug, doctor, benefit preferences), and lump-sum payments for lead generation. Brokerages also have an opportunity to equip their agents with a full product portfolio inclusive of life insurance, final expense, Affordable Care Ac...
2025 IRMAA: Slight increase in Medicare Part D IRMAA payments for some. Medicare Part D beneficiaries with annual income (MAGI) over $106,000 (individual) or over $212,000 for couples filing joint (see 2025 IRMAA rate charts) will pay the Medicare Part D Income-Related Monthly Adjustment...
also has a monthly charge that varies depending on which plan you choose; the average Part D total premium for 2025 will be about $46.50 per month, down from $53.95 in 2024. In addition to premium costs, you'll also be subject to co-payments, deductibles and other out-of-pocket costs...