Modern Healthcare Staff Alison Bennett See All Staff Page Recent Stories CMS outlines limits on Medicare Advantage AI usage Medicare Advantage insurers may use artificial intelligence and similar tools to inform coverage decisions, not to make them, according to guidance from the Centers for Medicare and Medicaid Services. Medicare Advantage plans face new rate cut under CMS proposal The latest cut sustains a string of regulatory actions unfavorable to Medicare Advantage insurers, which are likely to plead with the Centers for Medicare and Medicaid Services and Congress for relief. MedStar settles federal disability discrimination charges MedStar Health allegedly forbade family members and other support people from accompanying patients with disablities for treatments. Medicare ACO participation spiked in 2024, CMS says The Centers for Medicare and Medicaid Services aims to have all fee-for-service Medicare beneficiaries in accountable care arrangements by 2030. CMS seeks input on Medicare Advantage transparency policy The Centers for Medicare and Medicaid Services may collect more information about Medicare Advantage insurer practices such as prior authorizations and claims denials. Doctors facing Medicare cut seek new payment system Physician groups have long decried Medicare's Merit-based Incentive Payment System and want it replaced. Congress is focused elsewhere. CMS unveils integrated mental health pilot program Medicare and Medicaid beneficiaries will have access to interprofessional care teams and community resources under the Innovation in Behavioral Health Model. CMS rule sets deadlines for prior authorizations UnitedHealth Group, Cigna and other health insurers began relaxing prior authorization policies last year under pressure from providers, patients and policymakers. U.S. proposes public provider accessibility standards The Justice Department aims to apply the Americans with Disabilities Act to diagnostic medical equipment used by publicly owned healthcare providers. Feds to propose new disability access requirements for medical equipment The pending Justice Department regulation aligns with recent Health and Human Services Department rules aiming to improve healthcare for people with disabilities. Medicare proposes observation status appeals process Federal courts have ruled the Centers for Medicare and Medicaid Services must allow Medicare beneficiaries to appeal when their hospital care is designated as observation and not covered under Part A. Under federal pressure, states work to boost Medicaid enrollment The Biden administration is increasing its efforts to get states to restore millions of people to Medicaid coverage. States are responding. CMS may withhold Medicaid funding over redeterminations issues The Centers for Medicare and Medicaid Services plans to exert new enforcement authority against states after nearly 12 million people lost Medicaid coverage this year. Nursing home staffing rule finds scant political support President Joe Biden's signature nursing home safety and quality proposal faces intense industry opposition and bipartisan skepticism on Capitol Hill. Medicare Advantage plans ducking new coverage rules, AHA claims The Centers for Medicare and Medicaid Services issued a regulation this year that requires Medicare Advantage plans to cover the same services as traditional Medicare. Load More Sponsored Content