On February 16, 2023, Representatives Pramila Jayapal (WA-07), Rosa DeLauro (CT-03), and Jan Schakowsky (IL-09) led a letter of 70 members of the U.S. House of Representatives calling on the Centers for Medicare & Medicaid Services (CMS) to … [Read more...] about 70 Members of Congress Call for Medicare Advantage Reforms, Including Reining in Overpayments
Medicare Advantage
Center for Medicare Advocacy Comments on Proposed Part C & D Rule
As noted in this December 2022 CMA Alert, CMS released a proposed rule for Medicare Advantage and Part D for 2024 available here (87 Fed Register 79452, December 27, 2022). CMS also published a press release and accompanying fact sheet … [Read more...] about Center for Medicare Advocacy Comments on Proposed Part C & D Rule
Insurance Industry Response to Proposed Medicare Advantage Payment for 2024
“Our Profits are The Sky is Falling!”This is the time of year – between the Centers for Medicare & Medicaid Services’ (CMS) release of proposed Medicare Advantage (MA) payment rates for the following year and the finalization of these … [Read more...] about Insurance Industry Response to Proposed Medicare Advantage Payment for 2024
Traditional Medicare or Medicare Advantage?
A Case Study in Favor of Traditional Medicare“Should I choose traditional Medicare with a supplement plan or a Medicare Advantage plan?”This is a question Center for Medicare Advocacy (Center) attorneys and advocates hear increasingly often. … [Read more...] about Traditional Medicare or Medicare Advantage?
Medicare Advantage Updates – Audits, Payment, and Prior Authorization
There is consistent and growing evidence that Medicare Advantage (MA) plans are paid more on average than traditional Medicare for a given beneficiary, and such payments are causing significant challenges for Medicare’s financial sustainability. … [Read more...] about Medicare Advantage Updates – Audits, Payment, and Prior Authorization
Center for Medicare Advocacy Statement on Recent Medicare Advantage Payment Policies and Proposals
A Step in the Right Direction, But Not Enough to Stem Wasteful OverpaymentsAs documented in various CMA Alerts, there is consistent and growing evidence that Medicare Advantage (MA) plans are paid more on average than traditional Medicare spends … [Read more...] about Center for Medicare Advocacy Statement on Recent Medicare Advantage Payment Policies and Proposals
Medicare Advantage Round-Up
On December 7, the Medicare Annual Coordinated Election Period (AEP) ended. This is the period during which individuals with Medicare can make coverage choices for the coming year. One thing that sets this AEP apart from prior years’ is that we … [Read more...] about Medicare Advantage Round-Up
CMS Issues Proposed Rules Impacting Medicare Advantage – Part C & D Rule for 2024, and Separate Prior Authorization Rule
As the Center for Medicare Advocacy has long noted, the Medicare Advantage (MA) program is in significant need of heighted regulation and oversight, not just for the sake of the Medicare program’s financial footing, but for the sake of the … [Read more...] about CMS Issues Proposed Rules Impacting Medicare Advantage – Part C & D Rule for 2024, and Separate Prior Authorization Rule
Medicare Annual Enrollment Period Ends December 7th
The Medicare Annual Coordinated Election Period (AEP) – the period during which individuals with Medicare can make coverage choices for the coming year – ends next Wednesday, December 7th. During this time, people can enroll in, switch, or get … [Read more...] about Medicare Annual Enrollment Period Ends December 7th
Disputes with Medicare Advantage Plans: Know the Difference Between Appeals and Grievances
Under Medicare law, Medicare Advantage plans and stand-alone Part D plans (“Plans”) must follow certain rules when enrollees disagree with Plan health care coverage determinations. Under the law, there are two distinct methods for raising issues with … [Read more...] about Disputes with Medicare Advantage Plans: Know the Difference Between Appeals and Grievances