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Medicare Advantage

Providers feel shut out from managed care


YARMOUTH, Maine – Record numbers of beneficiaries are enrolling in Medicare Advantage plans, but with many of those plans locking down their markets to a handful of providers, that doesn’t always translate to an increase in business for HME providers.

In brief: Premiums for Medicare Advantage remain stable, complex rehab stakeholders launch petition


WASHINGTON – There won’t be a cat-and-mouse game with premiums for Medicare Advantage plans this year.

Premiums for Medicare Advantage plans to remain stable in 2016


WASHINGTON – There won’t be a cat-and-mouse game with premiums for Medicare Advantage plans this year.

In brief: CMS limits scope of audits, O&P fight rages on


WASHINGTON – For redeterminations and reconsiderations of claims denied following a post-payment review or audit, CMS has instructed the MACs and QICs to limit their scope to the reason the claim or line item was initially denied, according to a recent MLN Matters

CMS targets Medicare Advantage for alternative model


BALTIMORE – CMS has announced plans to test a Value-Based Insurance Design Model to improve care and reduce costs in Medicare Advantage plans.

United Health dominates Medicare Advantage market


NEW YORK – There is little or no competition in the Medicare Advantage market in 97% of U.S. counties, according to a new study from the Commonwealth Fund.

CMS reverses cut to MA plans


WASHINGTON – CMS has reversed a small cut to 2016 payments to Medicare Advantage plans.

CMS holds steady on Medicare Advantage


WASHINGTON – CMS has proposed a very small decrease in payments to Medicare Advantage plans for 2016, the agency announced Feb. 20.

Medicare Advantage enrollment on the rise


YARMOUTH, Maine – Medicare has said it expects enrollment in Medicare Advantage plans to increase, a trend providers say they are seeing already.

CMS touts popularity, value of MA plans


WASHINGTON – Enrollment in Medicare Advantage (MA) plans in 2015 is projected to increase to a new all-time high, CMS announced Sept. 18.

Premiums are expected to remain affordable, as well, the agency says.