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Medicare Advantage Benefit Trends for 2022: A First Glimpse

Each year, the health plans that participate in Medicare Advantage (MA) program compete vigorously for new members. This vigorous competition has fueled the program’s 10% annual growth rate in recent years. MA plans can...more

An Early Look at 2021 Medicare Advantage Benefits: Part II

Medicare Advantage (MA) is the private plan option in the Medicare program. Enrollment in the program has grown nearly 10% a year in recent years and now tops 25 million. More than one-third of Medicare beneficiaries (people...more

An Early Look at 2021 Medicare Advantage Benefits: Part I

Medicare Advantage (MA) is the rapidly growing private plan option in the Medicare program. More than one-third of all Medicare beneficiaries choose MA — more than 24 million people. The program has grown nearly 10% year over...more

2020 Vision: New Information on 2020 Medicare Advantage Benefits, Part II

Medicare Advantage (MA) is the private plan option in the Medicare program. Over the last few years, the program has grown rapidly, nearly 10% a year. More than one-third of Medicare beneficiaries (people with Medicare) have...more

New CMS Regulation Proposes Another Set of Plan-Friendly Tweaks to Medicare Advantage

On February 5, the Centers for Medicare and Medicaid Services (CMS) proposed several interesting tweaks to the Medicare Advantage (MA) and Medicare Part D programs through an 895-page proposed regulation, Contract Year 2021...more

Increasing the Advantage of Medicare Advantage: Decoding President Trump’s Medicare Executive Order

On October 3, President Donald Trump signed an executive order (EO) focused on the Medicare program, titled, “Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors.” The EO offers expected political...more

The Pronounced Importance of an Unpronounceable Acronym: New Guidance on SSBCI in Medicare Advantage

On April 24, Centers for Medicare and Medicaid Services (CMS) issued a memo to Medicare Advantage (MA) plan sponsors detailing the scope of Special Supplemental Benefits for the Chronically Ill (SSBCI). Established by the...more

Medicare Advantage Plan Adoption of New Flex Benefits in 2019

Medicare Advantage, the private plan option in the Medicare program, is growing rapidly. Currently, 22 million people choose Medicare Advantage — more than one third of people with Medicare — and that number is expected to...more

Trick or Treat? Expected and Surprising Provisions in the New Medicare Advantage Regulation

On October 26, the Centers for Medicare and Medicaid Services (CMS) released a 362-page proposed regulation that makes changes to three expected areas: - New telehealth flexibilities for Medicare Advantage (MA) plans....more

A New Advantage in Medicare: New Benefit Flexibilities Will Change Medicare Advantage

A provision included in the recently enacted budget law will now make it much easier for Medicare Advantage (MA) plans to offer a wide array of supplemental benefits within their plans. This will create new opportunities for...more

In Removing HSD Tables From Applications, CMS Opens the Door to Medicare Advantage Growth

Recently, the Centers for Medicare & Medicaid Services (CMS) released its draft 2019 Medicare Advantage application. Health plans seeking to participate in the Medicare Advantage (MA) program for the first time or expanding...more

An Unsettling Settlement: Health Plan to Pay $32 Million to Settle Coding and Provider Network Misrepresentation Charge

On May 30, the Department of Justice (DOJ) announced that it reached a settlement with commonly-owned Freedom Health Inc. and Optimum Healthcare, Inc. (Freedom Health) — two Tampa, Florida, managed care plans — to settle...more

Broad Examination of Narrow Networks: First-of-Its-Kind Study Examines Hospitals in Medicare Advantage Plans

On June 20, 2016, The Kaiser Family Foundation issued the first ever broad-based study of Medicare Advantage hospital networks. The study — "Medicare Advantage Hospital Networks: How Much Do They Vary?"— analyzed 409 plans in...more

6/23/2016  /  HMOs , Hospitals , Medicare , Medicare Advantage

Whether Naughty or Nice, Recovery Audit Contractors Are Coming to Medicare Advantage

During the holiday season lull, the Centers for Medicare and Medicaid Services (CMS) issued a weighty document. The agency put out a draft statement of work to procure Recovery Audit Contractors (RACs) for the Medicare...more

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