FierceHealthIT

OCTOBER 10, 2024

Just 40% of Medicare Advantage prescription drug plans offered in 2025 achieved a score of four stars or higher, the Centers for Medicare & Medicaid Services (CMS) revealed Oct. It's harder than ever for Medicare Advantage plans to score well on star ratings. Here's how they performed for 2025.

Medicare 125

Medicare 125

FierceHealthIT

NOVEMBER 2, 2024

The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% cut to physician payments in 2025 despite protest from major industry groups. | cut to physician payments in 2025 despite protest from major industry groups.

Medicare 131

Medicare 131

FierceHealthIT

OCTOBER 16, 2024

Medicare's annual enrollment period is officially underway, and, to assist beneficiaries in selecting plans, U.S. Medicare's annual enrollment period is officially underway, and to assist beneficiaries in selecting plans, U.S. News & World Report has released its list of the best Medicare Advantage and Part D insurers.

Medicare 112

Medicare 112

FierceHealthIT

SEPTEMBER 27, 2024

Medicare's open enrollment window opens in a few weeks, and the Centers for Medicare & Medicaid Services is offering a broad look at the landscape around Medicare Advantage and Part D before si | Medicare's open enrollment window opens in a few weeks, and the Centers for Medicare & Medicaid Services is offering a broad look at the (..)

Medicare 119

Medicare 119

FierceHealthIT

SEPTEMBER 20, 2024

Cigna is reshaping its Medicare Advantage (MA) plan lineup across eight states, affecting members in 36 health plans. Cigna is the latest company to rethink its Medicare Advantage offerings, choosing to cut plans in eight states including Florida.

Medicare 123

Medicare 123

FierceHealthIT

SEPTEMBER 4, 2024

Humana reaffirmed its full-year guidance but is leaving 13 Medicare Advantage (MA) markets next year, Chief Financial Officer Susan Diamond said during the Wells Fargo Healthcare Conference on Wedn | Humana is pulling back from Medicare Advantage markets and cutting benefits next year.

Medicare 125

Medicare 125

FierceHealthIT

OCTOBER 15, 2024

CareNu is starting to sign members up for health insurance through its Medicare Advantage plan for the first time. CareNu's subsidiary is launching an Institutional Special Needs Medicare Advantage plan in Florida for patients with chronic illness.

Medicare 122

Medicare 122

Health Populi

AUGUST 3, 2021

“You can trust us to help you find the right Medicare coverage for you and your lifestyle,” the tagline reads. It is, specifically, Midwest Heritage, Hy-Vee’s banking, insurance and investments subsidiary, that will implement the Medicare Aisle program.

Medicare 317

Medicare Primary Care Mental health Digital Health 317

FierceHealthIT

NOVEMBER 4, 2024

Days before the 2024 presidential election, the Centers for Medicare & Medicaid Services (CMS) released an unpublished version of the final calendar year 2025 physician fee schedule final rule | Digital therapeutics, telehealth, rural heath clinics and opioid treatment programs all got updates in the final 2025 Medicare physician fee schedule rule, (..)

Medicare 126

Medicare Digital Health Health Policy Telehealth 126

FierceHealthIT

AUGUST 13, 2024

Fifty-four percent of Medicare beneficiaries are enrolled in a private Medicare Advantage plan, and in seven states that figure tops 60%, according to a new report from KFF.

Medicare 130

Medicare 130

Mobi Health News

MAY 8, 2023

According to an audit by the Office of the Inspector General, Medicare improperly paid for $580 million of psychotherapy care, including $348 million of telehealth services, during the first year of the COVID-19 public health emergency.

Medicare 272

Medicare Telehealth Public Health 272

FierceHealthIT

AUGUST 15, 2024

The Centers for Medicare & Medicaid Services offered the first look at the potential savings generated by the first crop of Medicare drug price negotiations. | The Centers for Medicare & Medicaid Services offered the first look at the potential savings generated by the first crop of Medicare drug price negotiations.

Medicare 135

Medicare 135

Mobi Health News

AUGUST 11, 2022

Researchers found remote patient monitoring use among Medicare beneficiaries increased from 91 claims per 100,000 enrollees in February 2020 to 594 claims per 100,000 enrollees in September 2021.

Medicare 270

Medicare 270

FierceHealthIT

AUGUST 27, 2024

A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars—only to abruptly back off amid an “uproar” fr | Filings and testimonies in a multibillion-dollar Justice Department civil fraud case against UnitedHealth Group outline industry pressure that led the (..)

Medicare 131

Medicare 131

FierceHealthIT

OCTOBER 11, 2024

Analyses of 2025 Medicare Advantage star ratings continue to pour in and not all of it bodes well for the conventional juggernauts. UnitedHealth and Humana saw star ratings decrease, whereas insurtechs celebrated their scores. We break down how all major insurers—and their investors—are reacting.

Medicare 125

Medicare 125

FierceHealthIT

JUNE 13, 2024

The Centers for Medicare & Medicaid Services (CMS) appears poised to rework Medicare Advantage (MA) quality ratings for this year, The Wall Street Journal

Medicare 127

Medicare 127

Healthcare IT Today

OCTOBER 23, 2024

The following is a guest article by David Lareau, CEO at Medicomp Systems A couple of years ago, we predicted an impending “explosion” of Medicare Advantage (MA) fraud and penalties. The Failure of Reactive Approaches The current approach to combating Medicare fraud is woefully inadequate. This mindset needs to change.

Medicare 73

Medicare Interoperability Healthcare Innovation Healthcare IT 73

FierceHealthIT

JUNE 26, 2024

Medicare enrollees will pay less for 64 prescription drugs from July though the end of September because drug companies raised prices faster than the rate of inflation, the Centers for Medicare &am | Medicare enrollees will see lower prices this quarter for certain drugs treating cancer and genetic disorders under action unveiled by CMS.

Medicare 125

Medicare 125

FierceHealthIT

JUNE 28, 2023

Medicare Advantage (MA) beneficiaries have fewer inpatient hospital stays and emergency department visits than beneficiaries in traditional fee-for-service Medicare, according to a

Medicare 123

Medicare 123

FierceHealthIT

SEPTEMBER 6, 2024

In its comments to the Centers for Medicare and Medicaid Services (CMS) on the draft CY2025 Medicare physician fee schedule (PFS), the American Medical Association badgered CMS on its pro | The American Medical Association submitted its comment letter to CMS on its draft CY2025 Medicare physician fee schedule.

Medicare 131

Medicare Telehealth 131

FierceHealthIT

APRIL 1, 2024

Insurers will feel resentful Monday as the feds opted to not reverse its decision to decrease Medicare Advantage benchmark payments by 0.16%, the Centers for Medicare and Medicaid announced. | CMS is not deviating from its January proposal to modestly rein in Medicare Advantage.

Medicare 143

Medicare 143

FierceHealthIT

SEPTEMBER 27, 2024

Many counties do not have medication for opioid use disorder (MOUD) services available through providers and treatment programs, and even in counties that do, Medicare and Medicaid beneficiaries of | A new report from HHS OIG looked at access to medication for opioid use disorder services and found many high need counties do not have specialized providers. (..)

Medicare 128

Medicare 128

FierceHealthIT

AUGUST 14, 2024

Getting seniors enrolled into the right Medicare plan is typically an inefficient process that many older patients find confusing and frustrating, spending hours on the phone with human call center | Startup Fair Square Medicare is using advancements with generative AI to build AI-based voice agents to screen seniors for Medicare coverage and improve (..)

Medicare 136

Medicare 136

FierceHealthIT

SEPTEMBER 30, 2024

As the calendar turns to October, the health insurance industry is gearing up for Medicare's annual enrollment period. | As the calendar turns to October, the health insurance industry is gearing up for Medicare's annual enrollment period.

Medicare 127

Medicare 127

FierceHealthIT

JULY 31, 2024

Humana affirmed its guidance for the year as it continues to face headwinds in the Medicare Advantage (MA) space. Humana affirmed its guidance for the year as it continues to face headwinds in the Medicare Advantage space.

Medicare 136

Medicare 136

FierceHealthIT

JULY 11, 2024

A recent lawsuit has pushed back against an industry-opposed Centers for Medicare & Medicaid Services (CMS) final rule on broker compensation in Medicare Advantage (MA) plans. | A district court in Texas is halting a federal rule that changes broker compensation and overhauls marketing to seniors.

Medicare 123

Medicare 123

FierceHealthIT

SEPTEMBER 11, 2024

Enrollees in both traditional Medicare and Medicare Advantage have cost-sharing obligations for behavioral health services, a GAO report shows.

Medicare 120

Medicare 120

FierceHealthIT

APRIL 30, 2024

CVS has quietly acquired Hella Health, a startup Medicare Advantage broker based in New York City, according to a post on LinkedIn. | CVS has quietly acquired Hella Health, a startup Medicare Advantage broker based in New York City, according to a post on LinkedIn.

Medicare 133

Medicare 133

FierceHealthIT

JUNE 17, 2024

LAS VEGAS—The eyes of many regulators and lawmakers are on Medicare Advantage (MA), and, amid rising criticism of the program, one industry leader is making the case that "nostalgia" for traditiona | LAS VEGAS—The eyes of many regulators and lawmakers are on Medicare Advantage, and amid rising criticism of the program, one industry leader (..)

Medicare 109

Medicare 109

FierceHealthIT

JUNE 17, 2024

Amazon Pharmacy is expanding its prescription drug subscription program, called RxPass, to Prime members on Medicare insurance. | The RxPass program, launched in January 2023, provides unlimited access to 60 eligible generic medications and will ship the medications to customers' homes for a flat monthly fee of $5.

Medicare 135

Medicare 135

FierceHealthIT

JANUARY 25, 2024

The Centers for Medicare & Medicaid Services is seeking feedback on how to increase transparency around Medicare Advantage and improve data capabilities. |

Medicare 130

Medicare 130

FierceHealthIT

MAY 6, 2024

The Hospital Insurance Trust Fund will be fully solvent for longer than previously projected, according to an annual Medicare Trustee report. | The Medicare Hospital Insurance Trust Fund won't run out of money as quickly as expected. Here's how federal officials are reacting.

Medicare 125

Medicare 125

FierceHealthIT

MAY 13, 2024

Online therapy provider Talkspace is making a big push into the Medicare market, rolling out to approximately 13 million members in 11 states. Talkspace plans to expand to all 33 million traditional Medicare members, coupled with several Medicare Advantage plans, across all 50 states by the end of the year.

Medicare 116

Medicare Mental health 116

FierceHealthIT

OCTOBER 18, 2023

Seniors are forced to navigate a convoluted Medicare Advantage (MA) landscape for healthcare coverage, often only to be denied care, experts told legislators during a Senate Finance Committee heari | Senators and experts agreed Wednesday that marketing practices from Medicare Advantage plans are often overwhelming for seniors.

Medicare 138

Medicare 138

FierceHealthIT

AUGUST 20, 2024

The upward trajectory of Medicare Advantage (MA) enrollment is likely to become an issue for hospitals and other healthcare providers forced to contend with plans’ prior authorization requirements | Prior authorization burdens and "a challenging contract negotiation season" on the horizon are likely headwinds for providers, and hospitals (..)

Medicare 130

Medicare 130

FierceHealthIT

FEBRUARY 28, 2024

Walgreens will now accept a slew of Medicare Advantage supplemental benefits online, including the option for home delivery, the company announced this week. Walgreens will now accept a slew of Medicare Advantage supplemental benefits online, including the option for home delivery, the company announced this week.

Medicare 117

Medicare 117

FierceHealthIT

MAY 9, 2024

Medicare Advantage plans have come under fire for upcoding that can increase the payouts they receive, and regulators point to health risk assessments as a likely culprit in this increase in coding | Medicare Advantage plans have come under fire for upcoding that can increase the payouts they receive, and regulators point to health risk assessments (..)

Medicare 121

Medicare 121