Fierce Healthcare

SEPTEMBER 20, 2024

Cigna is reshaping its Medicare Advantage (MA) plan lineup across eight states, affecting members in 36 health plans. Cigna is the latest company to rethink its Medicare Advantage offerings, choosing to cut plans in eight states including Florida.

Medicare 310

Medicare 310

Fierce Healthcare

OCTOBER 16, 2024

Medicare's annual enrollment period is officially underway, and, to assist beneficiaries in selecting plans, U.S. Medicare's annual enrollment period is officially underway, and to assist beneficiaries in selecting plans, U.S. News & World Report has released its list of the best Medicare Advantage and Part D insurers.

Medicare 284

Medicare 284

Fierce Healthcare

OCTOBER 29, 2024

Accountable care organizations saved Medicare $2.1 billion, the largest yearly savings in program history, in 2023, the Centers for Medicare & Medicaid Services revealed on Tuesday. Accountable care organizations (ACOs) saved Medicare $2.1

Medicare 327

Medicare Accountable Care Accountability Medicaid 327

Fierce Healthcare

NOVEMBER 2, 2024

The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% cut to physician payments in 2025 despite protest from major industry groups. | cut to physician payments in 2025 despite protest from major industry groups.

Medicare 330

Medicare Doctors Medicaid 330

Fierce Healthcare

SEPTEMBER 27, 2024

Medicare's open enrollment window opens in a few weeks, and the Centers for Medicare & Medicaid Services is offering a broad look at the landscape around Medicare Advantage and Part D before si | Medicare's open enrollment window opens in a few weeks, and the Centers for Medicare & Medicaid Services is offering a broad look at the (..)

Medicare 301

Medicare Medicaid 301

Fierce Healthcare

OCTOBER 15, 2024

CareNu is starting to sign members up for health insurance through its Medicare Advantage plan for the first time. CareNu's subsidiary is launching an Institutional Special Needs Medicare Advantage plan in Florida for patients with chronic illness.

Medicare 308

Medicare 308

Fierce Healthcare

AUGUST 13, 2024

Fifty-four percent of Medicare beneficiaries are enrolled in a private Medicare Advantage plan, and in seven states that figure tops 60%, according to a new report from KFF.

Medicare 327

Medicare 327

Fierce Healthcare

AUGUST 15, 2024

The Centers for Medicare & Medicaid Services offered the first look at the potential savings generated by the first crop of Medicare drug price negotiations. | The Centers for Medicare & Medicaid Services offered the first look at the potential savings generated by the first crop of Medicare drug price negotiations.

Medicare 338

Medicare Medicaid 338

Health Care Dive

SEPTEMBER 25, 2024

Regulators say Medicare needs more data and oversight to avoid fraud and misuse. Digital health advocates argue the service is still crucial for managing chronic conditions.

Medicare 325

Medicare Regulations 325

Health Care Dive

NOVEMBER 14, 2024

But the metric “is going to have a smaller weighting on star ratings moving forward,” the director of Medicare said. Regulators’ assessment of customer support centers has spurred recent lawsuits from UnitedHealthcare, Centene and Humana.

Medicare 314

Medicare Regulations 314

Fierce Healthcare

NOVEMBER 4, 2024

Days before the 2024 presidential election, the Centers for Medicare & Medicaid Services (CMS) released an unpublished version of the final calendar year 2025 physician fee schedule final rule | Digital therapeutics, telehealth, rural heath clinics and opioid treatment programs all got updates in the final 2025 Medicare physician fee schedule rule, (..)

Medicare 318

Medicare Medicaid 318

Fierce Healthcare

AUGUST 27, 2024

A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars—only to abruptly back off amid an “uproar” fr | Filings and testimonies in a multibillion-dollar Justice Department civil fraud case against UnitedHealth Group outline industry pressure that led the (..)

Medicare 330

Medicare 330

Health Care Dive

OCTOBER 23, 2024

The Better Medicare Alliance is warning of disruptions to care for America’s seniors, though MA premiums and major benefits are essentially unchanged next year.

Medicare 290

Medicare 290

Health Care Dive

JULY 18, 2024

The company uses AI to recommend Medicare Advantage, Medicare supplement and prescription drug plans based on enrollees’ healthcare preferences and needs.

Medicare 308

Medicare Healthcare 308

Fierce Healthcare

OCTOBER 11, 2024

Analyses of 2025 Medicare Advantage star ratings continue to pour in and not all of it bodes well for the conventional juggernauts. UnitedHealth and Humana saw star ratings decrease, whereas insurtechs celebrated their scores. We break down how all major insurers—and their investors—are reacting.

Medicare 315

Medicare 315

Fierce Healthcare

JUNE 28, 2023

Medicare Advantage (MA) beneficiaries have fewer inpatient hospital stays and emergency department visits than beneficiaries in traditional fee-for-service Medicare, according to a

Medicare 310

Medicare Hospitals 310

Fierce Healthcare

JUNE 13, 2024

The Centers for Medicare & Medicaid Services (CMS) appears poised to rework Medicare Advantage (MA) quality ratings for this year, The Wall Street Journal

Medicare 321

Medicare Medicaid 321

Fierce Healthcare

APRIL 1, 2024

Insurers will feel resentful Monday as the feds opted to not reverse its decision to decrease Medicare Advantage benchmark payments by 0.16%, the Centers for Medicare and Medicaid announced. | CMS is not deviating from its January proposal to modestly rein in Medicare Advantage.

Medicare 358

Medicare Medicaid 358

Fierce Healthcare

JUNE 26, 2024

Medicare enrollees will pay less for 64 prescription drugs from July though the end of September because drug companies raised prices faster than the rate of inflation, the Centers for Medicare &am | Medicare enrollees will see lower prices this quarter for certain drugs treating cancer and genetic disorders under action unveiled by CMS.

Medicare 315

Medicare 315

Fierce Healthcare

SEPTEMBER 27, 2024

Many counties do not have medication for opioid use disorder (MOUD) services available through providers and treatment programs, and even in counties that do, Medicare and Medicaid beneficiaries of | A new report from HHS OIG looked at access to medication for opioid use disorder services and found many high need counties do not have specialized providers. (..)

Medicaid 322

Medicaid Medicare 322

Fierce Healthcare

JULY 31, 2024

Humana affirmed its guidance for the year as it continues to face headwinds in the Medicare Advantage (MA) space. Humana affirmed its guidance for the year as it continues to face headwinds in the Medicare Advantage space.

Medicare 342

Medicare 342

Health Care Dive

AUGUST 27, 2024

If all newly eligible patients received semaglutide, Medicare Part D spending could increase by $34 billion to $145 billion each year, according to new research.

Medicare 317

Medicare 317

Health Care Dive

SEPTEMBER 25, 2024

Aberrant billing for urinary catheters last year could have made it harder for ACOs in Medicare to bring in shared savings. That’s no longer the case under a new final rule.

Accountable Care 306

Accountable Care Accountability Medicare 306

Fierce Healthcare

SEPTEMBER 6, 2024

In its comments to the Centers for Medicare and Medicaid Services (CMS) on the draft CY2025 Medicare physician fee schedule (PFS), the American Medical Association badgered CMS on its pro | The American Medical Association submitted its comment letter to CMS on its draft CY2025 Medicare physician fee schedule.

Medicare 330

Medicare Doctors Medicaid 330

Fierce Healthcare

AUGUST 14, 2024

Getting seniors enrolled into the right Medicare plan is typically an inefficient process that many older patients find confusing and frustrating, spending hours on the phone with human call center | Startup Fair Square Medicare is using advancements with generative AI to build AI-based voice agents to screen seniors for Medicare coverage and improve (..)

Medicare 342

Medicare 342

Health Care Dive

JUNE 18, 2024

RxPass is now available to more than 50 million Medicare members after Amazon brought it into compliance with the insurance program’s regulatory standards.

Medicare 321

Medicare 321

Fierce Healthcare

JULY 11, 2024

A recent lawsuit has pushed back against an industry-opposed Centers for Medicare & Medicaid Services (CMS) final rule on broker compensation in Medicare Advantage (MA) plans. | A district court in Texas is halting a federal rule that changes broker compensation and overhauls marketing to seniors.

Medicare 310

Medicare Medicaid 310

Fierce Healthcare

JUNE 17, 2024

Amazon Pharmacy is expanding its prescription drug subscription program, called RxPass, to Prime members on Medicare insurance. | The RxPass program, launched in January 2023, provides unlimited access to 60 eligible generic medications and will ship the medications to customers' homes for a flat monthly fee of $5.

Medicare 338

Medicare 338

Fierce Healthcare

SEPTEMBER 30, 2024

As the calendar turns to October, the health insurance industry is gearing up for Medicare's annual enrollment period. | As the calendar turns to October, the health insurance industry is gearing up for Medicare's annual enrollment period.

Medicare 319

Medicare 319

Fierce Healthcare

APRIL 30, 2024

CVS has quietly acquired Hella Health, a startup Medicare Advantage broker based in New York City, according to a post on LinkedIn. | CVS has quietly acquired Hella Health, a startup Medicare Advantage broker based in New York City, according to a post on LinkedIn.

Medicare 333

Medicare 333

Fierce Healthcare

JUNE 17, 2024

LAS VEGAS—The eyes of many regulators and lawmakers are on Medicare Advantage (MA), and, amid rising criticism of the program, one industry leader is making the case that "nostalgia" for traditiona | LAS VEGAS—The eyes of many regulators and lawmakers are on Medicare Advantage, and amid rising criticism of the program, one industry leader (..)

Medicare 276

Medicare Regulations 276

Fierce Healthcare

SEPTEMBER 11, 2024

Enrollees in both traditional Medicare and Medicare Advantage have cost-sharing obligations for behavioral health services, a GAO report shows.

Medicare 304

Medicare 304

Fierce Healthcare

JANUARY 25, 2024

The Centers for Medicare & Medicaid Services is seeking feedback on how to increase transparency around Medicare Advantage and improve data capabilities. |

Medicare 327

Medicare Medicaid Integration 327

Fierce Healthcare

OCTOBER 18, 2023

Seniors are forced to navigate a convoluted Medicare Advantage (MA) landscape for healthcare coverage, often only to be denied care, experts told legislators during a Senate Finance Committee heari | Senators and experts agreed Wednesday that marketing practices from Medicare Advantage plans are often overwhelming for seniors.

Medicare 347

Medicare Healthcare 347

Fierce Healthcare

MAY 6, 2024

The Hospital Insurance Trust Fund will be fully solvent for longer than previously projected, according to an annual Medicare Trustee report. | The Medicare Hospital Insurance Trust Fund won't run out of money as quickly as expected. Here's how federal officials are reacting.

Medicare 315

Medicare Hospitals 315

Fierce Healthcare

AUGUST 20, 2024

The upward trajectory of Medicare Advantage (MA) enrollment is likely to become an issue for hospitals and other healthcare providers forced to contend with plans’ prior authorization requirements | Prior authorization burdens and "a challenging contract negotiation season" on the horizon are likely headwinds for providers, and hospitals (..)

Medicare 327

Medicare Hospitals Healthcare Providers Healthcare 327

Fierce Healthcare

FEBRUARY 28, 2024

Walgreens will now accept a slew of Medicare Advantage supplemental benefits online, including the option for home delivery, the company announced this week. Walgreens will now accept a slew of Medicare Advantage supplemental benefits online, including the option for home delivery, the company announced this week.

Medicare 296

Medicare 296