Humana Inc. reports that it is cooperating with a Department of Justice inquiry into whether it exaggerated the severity of elderly patients' illnesses to generate higher Medicare reimbursements.
If you operate a senior living facility, here is something to put at the very top of your to-do list: Survey your residents to understand the choices they have made in the Medicare open enrollment period, which is closing tomorrow.
Supporters of Medicare Advantage program are roundly criticizing President Obama's fiscal 2016 budget plan to slash more than $36 billion in its funding over the coming decade.
Americans are the most worried about losing their eyesight as they age, poll says .... AHCA says MedPAC Chairman is 'spot-on' with three-day stay comments ... Medicare Advantage enrollment rises for fifth straight year, CMS says.
Medicare Advantage organizations are unresponsive to provider questions, long-term care professionals tell CMSAugust 07, 2014
Several skilled nursing facility workers expressed frustration regarding communications with Medicare Advantage organizations during a public call with government officials Wednesday. Centers for Medicare & Medicaid Services representatives acknowledged that provider frustration in this area has been an ongoing issue, but they said that their hands essentially are tied.
The Centers for Medicare & Medicaid Services will hold its Medicare Advantage & Prescription Drug Oversight & Enforcement 2014 Program Audits conference on Tuesday, June 24 .It is designed to "provide insight into how MA and Part D organizations can best prepare for a CMS performance audit." Participants can attend in-person or virtually.
If you serve elderly populations in a long-term care or nursing facility, you have my respect — for the compassion you bring to work each day and the challenges you must face.
Continuing care retirement communities should ask residents about their health plans twice a year, to keep tabs on the increasing number of seniors being shifted into Medicare Advantage, an expert told an audience of long-term care professionals in Chicago Wednesday.
CMS recently finalized Medicare Advantage plan payment rates for Calendar Year 2015 and announced other changes to payment and program policies for MA and Part D plans. Although the announcement included some positive changes for plans, the overall impact is mostly negative.
Medicare beneficiaries would be paid to create advance directives and store them in an easy-access system if a recently proposed Senate bill were to become law.
Home health providers should be subject to Medicare reimbursement penalties based on hospital readmission rates, according to the Medicare Payment Advisory Commission.
Skilled nursing facilities may be reimbursed for maintenance therapy services performed by assistants, the Centers for Medicare & Medicaid Services clarified in a recent Medicare Benefit Policy manual revision. CMS officials announced and explained the revision in an Open Door Forum call Thursday.
There's been a lot of talk lately about what constitutes "comprehensive" health insurance coverage — and long-term care notably has not been part of this national conversation.
On Oct. 31 (an ironic coincidence?) a report from the Office of inspector General frighteningly said Medicare paid some $23 million in benefits for more than 17,000 dead people in 2011. And my husband says I waste money.
Washington-based Premera Blue Cross will enter the Medicare Advantage market in 2014, the company announced Oct. 1.
There will be fewer Medicare Advantage plans in 2014, according to a new analysis. The number of plans will drop to 2,522, which is around a 5% decrease, according to Avalere Health. Medicare Advantage can cover skilled nursing stays, and enrollment was up in 2012.
MedPAC calls for permanent reauthorization of Medicare Advantage plan covering nursing home residentsJanuary 14, 2013
The Medicare Advantage special needs plan that enrolls nursing home residents, set to expire at the end of 2014, will be permanently reauthorized if Congress acts on recommendations proposed by the Medicare Payment Advisory Commission (MedPAC).
In what has become a frequent event, the Inspector General at the Department of Health and Human Services has just issued yet another report that crows about heroic fraud-fighting efforts.
The Centers for Medicare & Medicaid Services is encouraging around 375,00 Medicare Advantage members to re-evaluate their plans.
Federal health officials have agreed to changes in Medicare coverage rules that would make it easier for beneficiaries with chronic conditions to qualify for nursing home stays, outpatient therapy and home healthcare services, according to reports.
Rep. Darrell Issa (R-CA) and other House Republicans issued a subpoena Monday to gain access to documents related to an Affordable Care Act Medicare Advantage demonstration project.
Affordable Care Act will reduce Medicare Advantage overpayments by $132 billion, Commonwealth Fund report findsOctober 18, 2012
Affordable Care Act reforms to Medicare Advantage (MA) will save the federal government $132 billion over 10 years, a new analysis has found.
Under a premium-support model for Medicare, six in 10 beneficiaries would see an increase in their premiums, a non-partisan study released Monday found.
Enrollment in Medicare Advantage has jumped by 28% since the Affordable Care Act was enacted in 2010, federal health officials said Wednesday.
Republican members of the House Ways and Means Committee have accused the Department of Health and Human Services of overstepping its authority in implementing a controversial Medicare Advantage demonstration project.
The federal government increasingly has spent potentially duplicative funds on individuals receiving healthcare benefits through the Veterans Administration and Medicare Advantage, a new analysis finds.
The Affordable Care Act will help Medicare save over $200 billion through 2016, according to government actuaries. But questions as to Medicare's long-term solvency remain, another report from Social Security and Medicare Boards of Trustees states.
Medicare Advantage plans with fewer than five stars on the quality scale should expect some form of audit, a Centers for Medicare & Medicaid official said this week.
A newly announced plan to mine data from Medicare Advantage plans might give many operators an unexpected spine shiver.
Recovery audit contractors and other quality assurance efforts allowed Medicare Advantage to reduce improper payments by $1.2 billion in 2011, according to a new government report.