Medicare Advantage
The AHA today urged swift action to hold MA plans accountable for inappropriately and illegally restricting access to medically necessary care.
AHA urges CMS to take swift action to hold Medicare Advantage (MA) plans accountable for inappropriately and illegally restricting beneficiary access to medically necessary care.
Medicare Advantage or MA Plans are another way for beneficiaries to get Medicare Part A and Part B coverage delivered through private insurance companies.
AHA's senior associate director of health insurance coverage discusses how commercial insurers are impacting patient care through their policies.
The Centers for Medicare & Medicaid Services (CMS) April 29 finalized its Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Program for Contract Year (CY) 2023.
CMS Friday finalized policy and technical changes to the Medicare Advantage and prescription drug benefit for contract year 2023.
The AHA continues to push back forcefully against MA plan policies that restrict or delay patient access to care, and add cost and burden to the health care system, while also contributing to health care worker burnout.
OIG found found 13% of coverage denials met Medicare coverage rules and 18% of payment denials met Medicare coverage and MA billing rules.
The final rule also codifies guidance on applying the changes beginning in contract year 2023.
The agency expects MA plans to see an average revenue increase of 8.5% under the final policies.