PayerOIG: Medicare Advantage Overpaid Anthem $3.5M
Anthem disputed the findings and rejected the recommendations in its rebuttal of the report.
TelehealthBusiness Leaders, Healthcare Stakeholders Urge Congress to Support Audio-only Telehealth
U.S. Chamber of Commerce, Harvard Pilgrim, Ascension, and others back audio-only Medicare Advantage bill.
StrategyHumana Health Plan Overcharged Medicare by Nearly $200M, Federal Audit Finds
The OIG's recommendation to repay, if finalized, would be "by far the largest" audit penalty ever imposed on a Medicare...
StrategyStudy Finds Ongoing Confusion Among Medicare Beneficiaries
GoHealth CMO, Paul Hain, MD, shares misconceptions Medicare beneficiaries have about Original Medicare and Medicare Advantage.
InnovationVirtual Care Key to Humana-Mercy Value-Based Contract
Medicare Advantage contract between Humana and Mercy expands to offer patients access to Mercy Virtual services. The arrangement is part...
StrategyMedicare Advantage Plan Selections Increased 16%
An eHealth analysis found a 16% increase of Medicare customers choosing Medicare Advantage plans during the 2021 annual enrollment period...
FinanceU.S. Healthcare Spending Grew 4.6% in 2019, Hit $3.8T
The rate of growth in 2019 was down slightly from the 4.7% rate in 2018 and consistent with the average...
TechnologyVirtual Care Visits up 136 Times Among Anthem Medicare Advantage Members
Visits in quarter ended May 2020 jump from 4.4K to 600K versus quarter in previous year.
StrategyKaiser Foundation MA Plan to Pay $6.3M to Settle False Claims Allegations.
The alleged violations occurred in 2011 and 2012, before Group Health Cooperative was acquired by Kaiser Permanente.
Covid-19CMS Readies Framework, Funding for Eventual COVID-19 Vaccine
Original Medicare and Medicare Advantage beneficiaries will get the vaccine at no cost.
Clinical CareCMS Announces 'Historically Low' Medicare Advantage Premiums, New Insulin Payment Model
More than 1,600 Medicare Advantage and Part D prescription plans will cap insulin monthly copays at no more than $35....
FinanceCMS' Proposal to Update MS-DRGs Based on Market Prices
A key objective is to enable updates to the MS-DRG payment rates that are no longer dependent on gross charges...