Tag: Medicare Advantage
In brief: PHE ends, CMS audits Medicare Advantage, CQRC calls for safeguards
February 3, 2023HME News Staff
WASHINGTON – President Joe Biden has announced that the public health emergency will end on May 11, 2023.
Under the last declaration in January, the PHE was set to end on April 11.
“The advance notice goes beyond HHS Secretary Xavier Becerra’s previous guidance to health care stakeholders that the agency would provide at least 60 days advance notice before ending the PHE,” AAHomecare noted in a bulletin.
Knowing when the PHE will end gives industry...
CMS set to expand Medicare Advantage audits
January 31, 2023HME News Staff
WASHINGTON – CMS has published a final rule in the Federal Register that codifies in regulation that, as part of the Medicare Advantage Risk Adjustment Data Validation (RADV) program, the agency will extrapolate audit findings beginning with payment year 2018.
“Protecting Medicare is one of my highest responsibilities as secretary, and this commonsense rule is a critical accountability measure that strengthens the Medicare Advantage program,” said Xavier Becerra, secretary...
BMA applauds proposed rule on PAs
December 7, 2022HME News Staff
WASHINGTON – The Better Medicare Alliance, a research and advocacy organization, believes a CMS proposed rule on prior authorizations for Medicare Advantage plans will help to coordinate safe, effective care and streamline the process. “While we continue to review the proposed rule in closer detail, we believe it complements our goals of protecting prior authorization’s essential function in coordinating safe, effective, high-value care, while also building on the Medicare Advantage...
Supplemental benefits on the rise for Medicare Advantage
November 22, 2022HME News Staff
WASHINGTON – Supplemental benefit offerings in Medicare Advantage, including in-home support services, caregiver support, home-based palliative care and therapeutic massage, increased for the upcoming year, according to a new brief commission by Better Medicare Alliance and prepared by the actuarial consulting firm Milliman. Overall, the number of Medicare Advantage plans to offer at least one of the five recently expanded supplemental benefits jumped 35% from 2022 to 2023, with the largest...
CMS monitors Medicare Advantage marketing tactics
October 24, 2022HME News Staff
WASHINGTON – CMS has issued a memo informing Medicare Advantage organizations and Part D sponsors of the agency’s monitoring activities during the 2023 Annual Election Period running from Oct. 15, 2022, to Dec. 7, 2023. “CMS is concerned about the marketing practices of all entities, including third-party marketing organizations,” the agency stated in the Oct. 19 memo. “We have reviewed thousands of complaints and hundreds of audio calls and have identified numerous...
In brief: Complex rehab momentum, telehealth risks, Medicare Advantage bill
September 16, 2022HME News Staff
WASHINGTON – A record 300-plus advocates participated in the NCART/NRRTS Virtual Congressional Fly-in on Sept. 14.
Those advocates, who included consumers, clinicians, providers, manufacturers, family members, caregivers and others, held meetings with 292 congressional offices throughout the day.
“In the weeks ahead, we will be carrying out the important task of following up with offices on the ‘congressional asks’ presented,” said Don Clayback in an...
BMA applauds House for passing Medicare Advantage bill
September 15, 2022HME News Staff
WASHINGTON – The Better Medicare Alliance applauds the House of Representatives for passing H.R. 3173, the Improving Seniors’ Timely Access to Care Act. The bipartisan legislation, which was sponsored by Reps. Suzan DelBen, D-Wash., Mike Kelly, R-Pa., Ami Bera, MD, D-Calif., and Larry Bucshon, MD, R-Ind., and endorsed by Better Medicare Alliance, would modernize the way Medicare Advantage uses prior authorization as a clinical tool to coordinate beneficiary care. “The Improving...
AAH locks in on Medicare Advantage
September 9, 2022Liz Beaulieu, Editor
WASHINGTON – While there has been a spotlight on Medicare Advantage recently, AAHomecare has been focused on the program for more than a year and it’s ready to go-live with a number of new resources for HME providers.
The resources include a digital brochure that spells out how providers reduce costs, improve outcomes and increase patient satisfaction, complete with embedded videos from patients and the association’s president and CEO, Tom Ryan.
“We’re...
Stakeholders on Medicare Advantage: ‘We need an avenue to go to’
September 2, 2022Liz Beaulieu, Editor
WASHINGTON – Industry stakeholders didn’t waste the opportunity to provide CMS with feedback on Medicare Advantage, telling the agency there’s an urgent need to improve oversight of the program.
Industry organizations, state and regional associations, and individual providers all submitted comments to a request for information before an Aug. 31 deadline, says Laura Williard, vice president of payer relations for AAHomecare.
“While there are some protections...
Medicare Advantage enrollment doubles
September 1, 2022HME News Staff
YARMOUTH, Maine – Medicare Advantage enrollment as a share of the eligible Medicare population has more than doubled from 2007 to 2022 (19% to 48%), according to a new analysis by the Kaiser Family Foundation.
Between 2021 and 2022, total enrollment grew by about 2.2 million beneficiaries, or 8%, a slightly slower growth rate than the prior year (10%).
The average Medicare beneficiary in 2022 has access to 39 Medicare Advantage plans, the largest number of options available...