Medicare Advantage
The Centers for Medicare & Medicaid Services Nov. 26 proposed changes to increase oversight of the Medicare Advantage and prescription drug programs for contract year 2026.
The AHA commends CMS for taking important steps to increase oversight of 2026 Medicare Advantage plans to help ensure enrollees have equal access to medically necessary health care services. The AHA has previously raised concerns about the negative effects of certain Medicare Advantage practices…
The AHA Nov. 11 voiced strong support for the Centers for Medicare & Medicaid Services’ proposed plan for data collection and reporting requirements for Medicare Advantage organizations. In addition, the AHA supports CMS’ proposed audit protocol, which would assess MAO compliance with MA…
November 11, 2024The Honorable Chiquita Brooks-LaSureAdministratorCenters for Medicare & Medicaid Services7500 Security BlvdBaltimore, MD 21244Re: CMS-10913 Medicare Part C Utilization Management Annual Data Submission and Audit Protocol Data RequestDear Administrator Brooks-LaSure:
A report released OCt. 23 by Kodiak Solutions found that Medicare Advantage plans classified three to four times as many hospital stays as observation visits from July 2023 through June 2024 when compared with traditional Medicare.
A report released Oct. 24 by the Office of Inspector General found that insurers received an estimated $7.5 billion in Medicare Advantage risk-adjustments for 2023 through health risk assessments and related medical record reviews.
Medicare open enrollment for 2025 began Oct. 15 and runs through Dec. 7. During the annual enrollment period, Medicare-eligible individuals can check their status, choose plans, or change plans during the open enrollment period.
The AHA Oct. 17 released its Health Care Plan Accountability Update, covering the latest developments in Medicare Advantage, legislation and regulation of private health insurers, as well as other resources from the last quarter.
A report released Oct. 17 by the Senate Homeland Security Committee’s investigative subcommittee scrutinizes some of the nation's largest Medicare Advantage insurers for their use of prior authorization and high rates of denials for certain types of care.
The Centers for Medicare & Medicaid Services Sept. 27 announced that average premiums, benefits and plan choices for Medicare Advantage and Part D will remain stable for 2025.