Commercial Insurer Accountability
Certain Medicare Advantage organizations have issued policies for the coming year that AHA believes do not fully adhere to requirements in the MA final rule for calendar year 2024, the association alerted the Centers for Medicare & Medicaid Services Nov. 20.
The American Hospital Association is deeply concerned that these practices will result in the maintenance of the status quo where MAOs apply their own coverage criteria that is more restrictive than Traditional Medicare proliferating the very behavior that CMS sought to address in the final rule,…
Health Plan Accountability Update, November 2023.
Payment denials by Medicare Advantage plans jumped 56% for the median health system between January 2022 and June 2023, contributing to a 28% decline in median cash reserves, according to the latest analysis of data from over 1,300 hospitals and health systems by Syntellis Performance Solutions and…
On November 15th, The American Hospital Association and a panel of experts from member hospitals and health systems discussed recent changes to the Medicare Advantage program that were finalized by the Centers for Medicare & Medicaid Services earlier this year. With new rules having gone…
On April 5, the Centers for Medicare…
The Centers for Medicare…
The Centers for Medicare & Medicaid Services Nov. 6 proposed changes to the Medicare Advantage and prescription drug programs for contract year 2025 intended to improve access to behavioral health care; ensure that agents and brokers enroll individuals in the best plan for their needs and that MA…
Over 30 members of the House of Representatives Nov. 3 urged the Centers for Medicare…
Trends in health insurance coverage are driving an increase in medical debt: these include inadequate enrollment in comprehensive health care coverage, growth in high-deductible and skinny health plans that intentionally push more costs onto patients, and misleading health plan practices that…