Medicare & Medicaid
The MA insurer sampled received at least $3.7 million of net overpayments for 2017 and 2018, the OIG found.
The Medicare Prescription Payment Plan is part of a suite of provisions aimed at lowering prescription drug and healthcare costs.
The percentage of America's rural hospitals operating in the red jumped from 43% to 50% in the last 12 months, the biggest leap yet.
The hospital claims that reimbursements for the drugs were determined by a payment model that is no longer valid.
The new cap will be annually indexed to the rate of change in Part D costs, providing potential relief for beneficiaries.
Every year Accrediting Organizations survey more than nine thousand Medicare/Medicaid program providers and suppliers.
Insurers generally have sufficient ratings headroom to withstand higher MA utilization rates, analysts found.
The state has seen some success in overhauling its provider payment structure in a push to advance value-based care.
The baby boomer population, which has driven the growth of MA, is reaching its peak potential of profitability.
The groups claim HHS' interpretation is too restrictive, leading to patient harm and financial distress for hospitals.