Disenrolling residents from MA plans leads to $7.85 million provider settlement with feds
By
Danielle Brown
Jul 01, 2022
A New York-based provider is settling allegations that it switched resident’s Medicare coverage to maximize its reimbursements for nearly $8 million.
Federal officials keep heat on MA plans over denials, delays
By
Danielle Brown
Jun 30, 2022
Congressional lawmakers are being urged to address weaknesses in Medicare Advantage plans in response to a federal watchdog report that found that the MA organizations have often improperly denied or delayed...
Group wants feds to probe Medicare Advantage plans wrongly denying care
By
Danielle Brown
May 25, 2022
An influential group of healthcare providers is calling on the Department of Justice to investigate Medicare Advantage organizations that have been found wrongly denying services to beneficiaries.
As Medicare Advantage grows, experts say, so do hard-to-fight denials
By
Kimberly Marselas
May 19, 2022
In addition to sagging Medicare Advantage payment rates, some skilled nursing providers also find themselves routinely doing battle to get paid for services they’ve already delivered.
MA enrollees with dementia report poor quality of care: study
By
Alicia Lasek
May 09, 2022
Medicare Advantage plans will be more incentivized to address gaps in care if consumer care assessments include more input from enrollees with dementia, investigators say.
Providers demand fixes after feds find MA plans wrongly delay or deny SNF services too often
By
Danielle Brown
May 02, 2022
Skilled nursing providers are demanding changes after a new federal report found that Medicare Advantage organizations (MAOs) have improperly denied or delayed services to beneficiaries to increase profits.
Clinical briefs for Monday, May 2
By
Alicia Lasek
May 02, 2022
OIG: Medicare Advantage plans denying, delaying services to beneficiaries … FDA approves first drug in its class to treat the heart ailment obstructive HCM … Intranasal insulin may boost function in...
8.5% payment boost to Medicare Advantage plans ‘clear signal of support’ from CMS: expert
By
Danielle Brown
Apr 06, 2022
The 8.5% boost in average revenue slated for Medicare Advantage plans in 2023 is proof of the Centers for Medicare & Medicaid Services support of the program and could mean improved payment for post-acute...
Discharges to home health outpace those to SNFs in 2021, report finds
By
Diane Eastabrook
Apr 03, 2022
Post-acute care discharge instructions rebounded to pre-pandemic levels last year with home health agencies outperforming skilled nursing facilities.
Providers applaud expected revenue increase for MA plans
By
Danielle Brown
Mar 28, 2022
The Centers for Medicare & Medicaid’s plan to create more options for the Medicare Advantage program through payment changes is being encouraged by the nation’s largest nursing home association.