Tag: Medicare Advantage
CMS announces pay increase for MA
April 9, 2025HME News Staff
WASHINGTON – Payments from the government to Medicare Advantage plans are expected to increase, on average, by 5.06% from 2025 to 2026.
This is an increase of 2.83% since the CY 2026 Advance Notice, largely attributable to an increase in the effective growth rate.
In its April 7 Calendar Year 2026 Rate Announcement for the Medicare Advantage and Medicare Part D Prescription Drug Programs, CMS explained:
The method for setting the effective growth rate is set in statute...
In brief: CMS increases MA payments, Resmed launches HSAT, Diabetes Atlas sparks action
April 9, 2025HME News Staff
WASHINGTON – Payments from the government to Medicare Advantage plans are expected to increase, on average, by 5.06% from 2025 to 2026.
This is an increase of 2.83% since the CY 2026 Advance Notice, largely attributable to an increase in the effective growth rate.
In its April 7 Calendar Year 2026 Rate Announcement for the Medicare Advantage and Medicare Part D Prescription Drug Programs, CMS explained:
The method for setting the effective growth rate is set in statute...
Medicare Advantage: Show your value
April 8, 2025Kim Cuce
Q. What are some strategies for providers to become part of narrow payer networks?
A. Over the past decade, provider networks for payers have become increasingly difficult for providers to join or remain a part of. Providers face several challenges in becoming part of these networks, including the need to demonstrate their value to payers and navigate complex contracting processes.
Providers aim to serve as many patients as possible, which requires being a trusted and convenient...
Hill hot list: Medicare Advantage & Dr. Oz
April 7, 2025HME News Staff
WASHINGTON – CMS issued a Medicare Advantage final rule on April 4 that does not finalize Part D coverage of obesity medications for Medicare and Medicaid.
The rule also does not finalize two other proposals: “Enhancing Health Equity Analyses: Annual Health Equity Analysis of Utilization Management Policies, Procedures”; and “Ensuring Equitable Access to Medicare Advantage Services—Guardrails for Artificial Intelligence.”
The rule does finalize...
In brief: AAH asks for exemption, CPAP therapy saves lives, Cigna closes MA sale
March 21, 2025HME News Staff
WASHINGTON – AAHomecare has asked the Trump Administration to exclude home medical equipment and supplies from current and proposed tariffs.
The administration in early March delayed proposed 25% tariff increases on products covered under the 2020 United States-Mexico-Canada Agreement (USMCA) until April. These potential new tariffs would join 20% tariffs on products from China that are already in effect.
Over the last two months, AAHomecare has engaged Capitol Hill on the need to exempt...
Cigna closes on sale of MA business
March 20, 2025HME News Staff
BLOOMFIELD, Conn. – The Cigna Group has completed the sale of its Medicare Advantage, Cigna Supplemental Benefits, Medicare Part D, and CareAllies businesses to Health Care Service Corporation (HCSC). The divestment of these assets streamlines The Cigna Group's portfolio and enables it to drive further innovation to support customers, it says. "We are proud of the positive impact we have made in people's lives and the unique value provided through our Medicare businesses and are...
Dr. Oz would seek to modernize MA
March 19, 2025Liz Beaulieu, Editor
WASHINGTON – While he’s on record as a big supporter of Medicare Advantage, Dr. Mehmet Oz told the Senate Finance Committee during a confirmation hearing on Friday that, if confirmed as CMS administrator, he would reform prior authorizations, which he called “a pox on the system.”
Oz told the committee that he would push for reducing the some 15,000 procedures and medications that require prior auths to 1,000. He also said he would push for speeding up approvals.
“If...
In brief: Owens & Minor explores P&HS sale, Grassley challenges UHC, CCS details burnout
February 28, 2025HME News Staff
RICHMOND, Va.– Owens & Minor is looking to sell off its Products & Healthcare Services business, while it remains “bullish” on its Patient Direct business.
The company made the announcement today, as part of its fourth quarter and full-year 2024 earnings results.
“Our commitment to directing capital toward the higher growth and higher margin Patient Direct segment has been increasingly evident in recent years and is consistent with our strategy,” said...
Sen. Grassley presses UnitedHealth Group on billing practices
February 27, 2025HME News Staff
WASHINGTON – Sen. Chuck Grassley, R-Iowa, chairman of the Senate Judiciary Committee and a former chairman of the Senate Finance Committee, has sent a letter to UnitedHealth Group CEO Andrew Witty demanding detailed information on the company’s Medicare billing practices.
Grassley’s letter cited reports of apparent fraud, waste and abuse at UnitedHealth Group, including efforts to diagnose enrollees with obscure revenue-generating diagnoses that were irrelevant or inaccurate....
Medicare Advantage: Evaluate, leverage and monitor
February 11, 2025Kim Cuce
Q. Do you have any key strategies to optimize working with Medicare Advantage plans?
A. Here a few recommendations that apply to navigating not only MAP plans but all insurances:
Evaluate your order cycle process: Implement a comprehensive strategy to review the entire order cycle from intake to final payment. Address root causes such as inefficient intake processes, lack of knowledge about payer policies and duplicate processes. Train customer service teams to identify...