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CMS pitches stricter oversight of organ procurement groups: 6 takeaways
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Artificial Intelligence Health Care Finance Legal Actions/Court Decisions Medicare Advantage

Eileen Cook December 14, 2023December 14, 2023 AI, Care Coordination and Integrated Case Management, Denied Medicare Advantage Claims, Medicare Advantage, nH Predict, Older Adults

Humana used AI tool from UnitedHealth to deny Medicare Advantage claims, lawsuit alleges

(By Jakob Emerson for Becker’s Hospital Review) Humana used an artificial intelligence tool owned by UnitedHealth Group to wrongfully deny Medicare

CMS Health Care Finance Health Care Redesign Legislative Update Medicare - General Medicare Advantage Part D/Prescription Drugs Price Transparency

Eileen Cook December 11, 2023December 11, 2023 Drug price Transparency, Healthcare Costs, medicare, Medicare Advantage, Medicare Advantage transparency, Medicare Part D, PBM

Medicare bills pass House committee: 3 things to know

(By Rylee Wilson for Becker’s Hospital Review) The House Energy and Commerce Committee advanced 19 pieces of legislation Dec. 7,

CMS Health Care Finance Medicare Advantage

Eileen Cook December 7, 2023December 7, 2023 CMS, medicare, Medicare Advantage, Medicare Part D, Mergers, Older Adults

Is the Medicare Advantage ‘gold rush’ over?

(By Rylee Wilson for Becker’s Hospital Review) The Medicare Advantage gold rush is slowing down, Wall Street Journal columnist David

CMS DHS -OIG Health Care Finance Medicare Advantage

Eileen Cook December 5, 2023December 5, 2023 CMS, DHS -Office of Inspector General, Healthcare Costs, Healthcare Finance, Medicare Advantage, Medicare Advantage Audits, Medicare Advantage Overpayments

10 payers audited for Medicare Advantage overpayments in 2023

(By Rylee Wilson for Becker’s Hospital Review) OIG audits found over $213 million in estimated Medicare Advantage overpayments in 2023.

DHS -OIG Medicare Advantage

Eileen Cook December 4, 2023December 4, 2023 CMS, DHS -Office of Inspector General, Medicare Advantage, Medicare Advantage Overpayments

OIG: Centene subsidiary received estimated $5.1M in Medicare Advantage overpayments

(By Rylee Wilson for Becker’s Hospital Review) SelectCare of Texas, a Centene subsidiary, received an estimated $5.1 million in net

Health Care Finance Health Insurance Medicare Advantage

Eileen Cook November 30, 2023November 30, 2023 Cigna Group, Health Insurance, Health Insurance companies, Humana, Medicare Advantage, Merger

Cigna, Humana ‘in talks’ to merge

(By Jakob Emerson for Becker’s Hospital Review) The Cigna Group and Humana are “in talks” to merge, The Wall Street

CMS Medicare - General Medicare Advantage Part D/Prescription Drugs

Eileen Cook November 30, 2023November 30, 2023 CMS, medicare, Medicare Advantage, Medicare Advantage Ads, Medicare Part D, Older Adults

Uncle Sam Wants You … to Help Stop Insurers’ Bogus Medicare Advantage Sales Tactics

(By Susan Jaffe for KFF Health News) After an unprecedented crackdown on misleading advertising claims by insurers selling private Medicare

CMS Emerging Health Issues Health Care Finance Health Insurance Medicare - General Medicare Advantage

Eileen Cook November 29, 2023November 29, 2023 Healthcare Costs, Hospital Inpatient Stay, medicare, Medicare Advantage, Medicare Advantage claims denials

Hospitals worry the plans are going to skirt federal regulations in reviewing hospital admissions

The American Hospital Association and the Federation of American Hospitals have voiced their concerns to the Centers for Medicare and

Emerging Health Issues Health Care - General Health Insurance Medicare Advantage Prior Authorization

Eileen Cook November 28, 2023November 28, 2023 Bipartisan Support, CMS, Medicare Advantage, Medicare Advantage claims denials, Medicare Advantage Prior Authorization

Bipartisan anger over Medicare Advantage denials on the rise

(By Rylee Wilson for Becker’s Hospital Review) Concerns about Medicare Advantage denials are on the rise in Washington, Politico reported

CMS Medicare - General Medicare Advantage Medigap Part D/Prescription Drugs

Eileen Cook November 27, 2023November 27, 2023 CMS, Healthcare Costs, medicare, Medicare Advantage, Medicare Part D, Older Adults

Medicare Advantage plans are not for everyone

There are many advantages to selecting a Medicare Advantage plan over traditional Medicare. Medicare Advantage plans have a limit on

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Latest Posts

Staying home, staying healthy
CMS pitches stricter oversight of organ procurement groups: 6 takeaways
Medicare Advantage Insurers Face New Curbs on Overcharges in Trump Plan That Reins in Payments
Helping you understand the Medicare’s ins and outs
Simple ways Veterans can protect against suicide risk right now

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