Medicare & Medicaid
Apparent differences in potentially avoidable hospitalizations among MA plans may be explained by shifting inpatient care to other settings.
For those with private insurance, coverage for telehealth and other remote care services will vary by plan after the end of the PHE.
CMS says it must examine whether a medication is reasonable and necessary while the FDA assesses whether medications are safe and effective.
This year, Medicare Advantage enrollment grew by just 1.5 million, below the pace set in previous years.
MA plans have adopted more restrictive criteria commonly used by commercial health insurance carriers, found consulting firm Crowe.
Patients in such models were 18% less likely to be admitted to the hospital and had a 9% lower 30-day readmission rate.
On April 1, states can begin disenrolling Medicaid enrollees for the first time since March 2020.
Three changes in the Advance Notice would, on average, cut MA rates in 2024 by 2.27%, AHIP says.
The proposed coverage of wheelchair power seat elevation equipment advances health equity, CMS says.
Payers' estimates of a more than 2% payment cut contradict projections from CMS, which projects a 1.03% increase for plans.