Tag: Medicare Advantage

In November, at the height of open enrollment season, U.S. Rehab’s Dan Fedor warned complex rehab providers about the Medicare Advantage plans that were being promoted by celebrities in TV commercials. The first thing providers need to know about these plans: what they’re promising Medicare beneficiaries. “A lot of (MA plans) are trying to lure (beneficiaries) from traditional Medicare to their MA plan,” said Fedor, director of reimbursement and education for U.S. Rehab,...

WASHINGTON - The Medicare Advantage average monthly plan premium is expected to decrease 11% to $21 in 2021, CMS has announced. Since 2017, the average monthly plan premium has decreased 34.2%, according to the agency, saving beneficiaries nearly $1.5 billion in costs. “This is the lowest that the average monthly premium for a Medicare Advantage plan has been since 2007,” CMS state. “In some states, including Alabama, Nevada, Michigan and Kentucky, beneficiaries will see average...

Dan_Fedor.jpg Many Medicare beneficiaries are being enticed by celebrities on TV to select a Medicare Advantage (MA) plan over original Medicare fee for service (FSS) with all the standard benefits of Medicare at a lower out-of-pocket cost. These plans often state they provide additional benefits, such as gym memberships, transportation and eyeglasses, so how can they provide more benefits with a lower cost? Seems too good to be true, doesn't it? How can these private, for-profit insurance...

WASHINGTON - CMS will increase average payments for health insurers that manage Medicare Advantage plans by 3.4% for 2019, the agency announced on April 1. CMS initially proposed a 1.84% increase, according to news reports. The agency will also make a number of policy changes to MA plans, including codifying key aspects of the Star Ratings system and revising the regulations controlling maximum out-of-pocket limits.

WASHINGTON - The standard monthly premium for Medicare Part B enrollees will be $134 for 2018, the same as 2017, CMS has announced.Some beneficiaries who were protected from Part B premium increases in prior years will have increases in 2018, but they will be offset by the increases in their Social Security benefits next year, CMS says.“Medicare's top priority is to ensure that beneficiaries have choices for affordable, high-quality care that fit their needs,” said CMS Administrator Seema...

WASHINGTON - Medicare Advantage premiums will remain stable and for the seventh straight year enrollment is projected to increase to a new all-time high, CMS announced Sept. 22. The average monthly premium will decrease by $1.19, from $32.59 in 2016 to $31.40 in 2017, about 4%. The majority of Medicare Advantage enrollees (67%) will experience no increase in premiums. Enrollment will increase to 18.5 million in 2017, a 60% increase from 2010. Thirty-two percent of all Medicare enrollees will be in...

WASHINGTON - The Government Accountability Office isn't pleased with CMS's progress in recovering substantial amounts of improper payments from Medicare Advantage organizations. The agency currently uses risk adjustment data validation audits to recover improper payments in the MA program. The GAO found that CMS's methodology does not result in the selection of contracts for audit that have the greatest potential for recovery of improper payments. The GAO also found “substantial delays”...

WASHINGTON - Payments to insurers that offer Medicare Advantage plans won't be as high as initially expected. Medicare Advantage payments will increase 0.85%, on average, for 2017, and insurers will likely see overall revenue increases of 3.05%, according to news reports. Earlier this year, CMS had indicated that payments would increase 1.35% and that insurers would see overall revenue increases of 3.55%. As part of a final rule published this week, the Obama administration has also proposed several...

WASHINGTON - Payments to insurers that offer Medicare Advantage plans won't be as high as initially expected. Medicare Advantage payments will increase 0.85%, on average, for 2017, and insurers will likely see overall revenue increases of 3.05%, according to news reports. Earlier this year, CMS had indicated that payments would increase 1.35% and that insurers would see overall revenue increases of 3.55%. As part of a final rule published this week, the Obama administration has also proposed several...

WASHINGTON - CMS has proposed changes to Medicare Advantage plans in 2017 that it believes will provide stable and fair payments, and improve the program. The net payment impact of the proposed changes would result in a modest increase of 1.35% on average Medicare Advantage plans, according to a press release. “This moderate growth is consistent with last year's update and reflects a similar pattern in Medicare fee-for-service,” the agency states. “Plans that improve the quality...