A new analysis in the New England Journal of Medicine found insurers may not offer a set of new benefits outlined in the Chronic Care Act to avoid chronically ill patients from joining their Medicare Advantage Plans.
HHS wants the U.S. Supreme Court to review a ruling that questions whether Medicare Advantage patients should factor into a provider's disproportionate-share hospital payment.
The CMS has started releasing information on millions of Medicare Advantage beneficiaries in an effort to help researchers better understand care trends for seniors.
April is National Minority Health Month. Along with the ongoing challenge of eliminating disparities in care, both insurance and access to care also vary based on race.
The CMS finalized a rule giving Medicare Advantage plans a bump in pay. The agency also will use more patient-care data when setting rates. The GAO has in the past questioned the accuracy of patient encounter data.
UPMC is still quietly fighting to end its relationship with Highmark Health's Medicare Advantage program in Pennsylvania.
Several lawmakers have asked the Trump administration to boost Puerto Rico's Medicare Advantage rates, which are now 43% below the national average, citing troubling access to care issues on the island.
The insurance industry's dominant lobbying group said a change to the way the CMS calculates Medicare Advantage payment rates would boost insurer payments and allow plans to enhance patient benefits.
Hospitals fear UnitedHealth's new emergency department payment policy, which comes on the heel's of rival insurer Anthem's controversial ED policy, could squeeze providers' revenue.
Insurer and provider groups railed against the CMS' proposal to use more patient-encounter data for Medicare Advantage plans' risk scores in 2019, but supported its suggestion to account for patients' mental health and substance abuse disorders.
Going months without significant aid or support, hospitals in Puerto Rico have had to mostly go it alone in terms of their recovery efforts. But the way forward seems to provide a ray of hope that could lead to a revamping of the health system.
A federal judge ruled the federal government hadn't shown that statements the insurer made about billing data accuracy would have affected payment of the claims.