CMS Holds the Line Against Insurance Industry Pressure, but Plans Remain Significantly Overpaid.As discussed in recent CMA Alerts (see, e.g., here and here), in late January this year the Centers for Medicare & Medicaid Services (CMS) issued … [Read more...] about Medicare Advantage Payment Rates for 2025 Released
Medicare Advantage
Study Examines Health Equity Differences between Medicare and Medicare Advantage
A recent Health Affairs study, Gaps In Quality Of Care Not Consistent Between Traditional Medicare, Medicare Advantage For Racial And Ethnic Groups, examined gaps in quality of care when comparing traditional Medicare and Medicare Advantage for … [Read more...] about Study Examines Health Equity Differences between Medicare and Medicare Advantage
Report on Improper Payments Shows Billions Wasted on Private Medicare Plans
The General Accounting Office (GAO) released a report on March 26, 2024 outlining payments that should not have been made, or were made in improper amounts by various government agencies. In its report, the GAO splits out payments in the … [Read more...] about Report on Improper Payments Shows Billions Wasted on Private Medicare Plans
Medicare Program Cannot Afford Medicare Advantage “Stability” – Especially as New Study Shows Inferior Home Health Care Provided by MA Plans
MA OverpaymentAs discussed in a recent CMA Alert (Feb. 22, 2024), the Centers for Medicare & Medicaid Services (CMS) has issued proposed MA payment rates for 2025 (“Rate Notice”), which will be finalized by April 1, 2024. As described … [Read more...] about Medicare Program Cannot Afford Medicare Advantage “Stability” – Especially as New Study Shows Inferior Home Health Care Provided by MA Plans
Medicare Advantage Plans Under Scrutiny by Department of Justice and Office of Inspector General
As discussed in a recent CMA Alert (Feb. 22, 2024), the Centers for Medicare & Medicaid Services (CMS) has issued proposed Medicare Advantage (MA) and Part D payment rates for 2025, comments to which are due March 1, 2024. MA plans are … [Read more...] about Medicare Advantage Plans Under Scrutiny by Department of Justice and Office of Inspector General
Medicare Advantage Proposed Payment for 2025 and Other Updates
The Centers for Medicare & Medicaid Services (CMS) has issued proposed Medicare Advantage (MA) and Part D payment rates for 2025. As discussed below, the insurance industry is already trying to pressure the agency to increase their payment in … [Read more...] about Medicare Advantage Proposed Payment for 2025 and Other Updates
Medicare Program Proposes to Increase Medicare Advantage Payment for 2025
On January 31, the Centers for Medicare & Medicaid Services (CMS) released an Advance Rate Notice proposing an overall pay increase to MA plans of 3.7% in 2025 (see CMS fact sheet here). According to CMS, “This is over a $16 billion increase in … [Read more...] about Medicare Program Proposes to Increase Medicare Advantage Payment for 2025
As Medicare Advantage Enrollment Grows, So Does Awareness of Problems
In an effort to foster informed decision-making by Medicare beneficiaries about their coverage options, the Center for Medicare Advocacy has long tried to highlight the trade-offs of enrolling in Medicare Advantage (MA) plans. In the past, … [Read more...] about As Medicare Advantage Enrollment Grows, So Does Awareness of Problems
Medicare Advantage Industry Support Letter Circulating in Senate – Center for Medicare Advocacy Urges Senators Not to Sign On
Medicare Advantage (MA) payment rates for the coming year are released early in the prior year. As of this writing, the proposed 2025 rates are imminent. As noted in previous CMA Alerts (see, e.g., this one from 2020), release of this information … [Read more...] about Medicare Advantage Industry Support Letter Circulating in Senate – Center for Medicare Advocacy Urges Senators Not to Sign On
Advocacy Tip for Medicare Advantage Enrollees Facing Difficulty Obtaining In-Network Care
In order to manage costs, Medicare Advantage (MA) plans are able to restrict their enrollees to a contracted network of health care providers that is “sufficient to provide access to covered services to meet the needs of the population served.”* Some … [Read more...] about Advocacy Tip for Medicare Advantage Enrollees Facing Difficulty Obtaining In-Network Care