The Centers for Medicare and Medicaid Services May 30 released a notice requesting comments on a proposed Medicare Advantage service level data collection  for initial determinations and appeals. The granular data will be used to enhance audit activities to ensure MA plans are operating in accordance with CMS guidelines and ensure appropriate access to covered services and benefits. CMS plans to use the information to hold MA plans accountable for their performance. Comments are due to the Office of Management and Budget by June 30. 

 

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The U.S. District Court for the Eastern District of Pennsylvania Aug. 5 granted a motion for the AHA and the Hospital and Healthsystem Association of…
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The Centers for Medicare & Medicaid Services July 27 released its Contract Year 2025 Part C and Part D Program Audit and Enforcement Report, outlining key…
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Medicare Advantage now covers more than half of eligible Medicare beneficiaries, making its impact on hospitals, health systems and patients impossible to…
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The Medicare Payment Advisory Commission June 15 released its June report to Congress that estimated the association between Medicare Advantage enrollment and…
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The Department of Health and Human Services Office of Inspector General June 11 released two reports on high rates of coverage denials by Medicare Advantage…
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Members of Congress and hospital and health system leaders today gathered for a briefing in Washington, D.C., to discuss how payment delays in Medicare…