Medicare Advantage and Medicaid

Selected news for the healthcare topic - Medicare Advantage, and the healthcare topic - Medicaid. We have 2,317 shared news items for this connection to-date.

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Date Headline (link) Source Relevant Snippet
9/17/2021 The Health 202: Experts debate coronavirus booster shots today Expect disagreements as FDA advisors debate merits and... Presented by Medicaid and Medicare Advantage Products Association of Puerto Rico (MMAPA) View in browser Presented by Medicaid and Medicare Advantage Products Association of Puerto Rico (MMAPA) By Alexandra Ellerbeck with research by Rachel Roubein Good morning! I'm the researcher for Health 202 and will be giving you the run-down on what you need to know about today's highly anticipated FDA ...
9/15/2021 Justice Department Targets Data Mining in Medicare Advantage Fraud Case Physicians Weekly ... Medicare Advantage program game federal billing regulations to overcharge for patient treatment. The suit names the medical records review company DxID and Independent Health Association, of Buffalo, which operates two Medicare Advantage plans. Betsy Gaffney, DxID‚Aos founder and CEO, also is named as a defendant. DxID, which shut down in August, is owned by Independent Health through another subsidiary. The Centers for Medicare & Medicaid Services, or CMS, pays the ...
9/15/2021 A New Medicare Advantage Fraud Case Is Taking Aim At Data Mining : Shots ... filed this week, is the first by the federal government to target a data mining company for allegedly helping a Medicare Advantage program to game federal billing regulations in a way that enables the plan ... are paid more for sicker patients The Centers for Medicare & Medicaid Services (CMS) pays the health plans using a complex formula called a ‚Aurisk score,‚Au which is intended to render higher rates for sicker ...
9/12/2021 Upcoming flu shot clinics at Tri-County Health Care in September, October Tri-County Health Care will be hosting several flu shot clinics during September and October. Clinics will be available in Wadena, Bertha, Henning, Ottertail and Sebeka. Tri-County is offering a significant discount for individuals paying at the time of the flu shot clinic, according to a Tri-County news release. Medicare Advantage Plans, Humana, Medicare, Medicaid and many other commercial insurances are accepted. Please confirm with your insurance company ...
9/1/2021 Florida Blue parent GuideWell to acquire Puerto Rico-based Triple-S Management | FierceHealthcare FierceHealthcare ... Medicare Advantage, Medicaid plans‚AuThe Transaction expands GuideWell‚Aos core insurance operations and positions Florida Blue and Triple-S Management for significant growth and meaningful value creation for the customers and communities we serve,‚Au said Pat Geraghty, president and CEO of GuideWell and Florida Blue.‚AuFlorida Blue and Triple-S Management are both recognized for their high-quality, affordable health care and their actions deeply rooted in supporting community ...
9/1/2021 Sutter Health to Pay $90 Million to Settle Medicare Fraud Allegations ... Medicare Advantage Plans. Specifically, Sutter Health allegedly knowingly submitted thousands of false diagnosis codes to Medicare Advantage Plans. The hospital system also allegedly intentionally caused the submission of thousands of false diagnosis codes to the Centers for Medicare and Medicaid Services (CMS). The CMS pays Medicare Advantage Plans a capitation amount using its risk-adjusted methodology for every beneficiary. Payments to plans are based on the demographic information and health ...
9/1/2021 Florida Blue parent GuideWell to acquire Puerto Rico-based Triple-S Management ... Medicare Advantage, Medicaid plans](//www.fiercehealthcare.com/payer/anthem-completes-acquisition-puerto-rico-based-medicare-advantage-medicaid-plans) ‚AuThe Transaction expands GuideWell‚Aos core insurance operations and positions Florida Blue and Triple-S Management for significant growth and meaningful value creation for the customers and communities we serve,‚Au said Pat Geraghty, president and CEO of GuideWell and Florida Blue. ‚AuFlorida Blue and Triple-S Management are both recognized for their high ...
8/31/2021 Sutter Health to pay $90M to resolve False Claims allegations - MedCity News MedCity News Sutter Health has agreed to pay $90 million to settle allegations that it committed Medicare Advantage fraud.The settlement resolves claims brought under the whistleblower provisions of the False Claims Act by Kathy Ormsby, a ... for certain Medicare Advantage beneficiaries to the Centers for Medicare & Medicaid Services. As a result, the health system received inflated payments.Further, even after Sutter Health became aware of these unsupported codes, it did not ...
8/31/2021 Hospitals say Medicare Advantage delays contribute to backlogs Modern Healthcare Hospitals in states with high COVID-19 case rates say restrictions set by Medicare Advantage plans are making it hard for them to discharge patients to other providers, exacerbating bed shortages. The issue centers on ... hospital associations have called on the Centers for Medicare and Medicaid Services to require the plans to waive any utilization management practices that delay patient transfers from hospitals to lower levels of care during the ...
8/31/2021 Social Security's Finances Remain Strong, Annual Trustees Reports Show ... Medicaid Services should do more to ensure that insurance corporations offering Medicare Advantage plans get their costs under control. These wealthy corporations made commitments to deliver health care services at a lower cost per beneficiary than traditional Medicare. Their failure to do so cost the Medicare Trust Fund $7 billion in 2018 alone. ‚AuThe Trustees also noted that Medicare Part D prescription drug costs continue to increase faster than the ...
8/27/2021 5 recent payer-provider feuds, agreements Becker's Hospital Review Here are five recent articles posted by Becker's Hospital Review since Aug. 18 that concern payer-provider relationships. 1. Leon Medical Centers Health Plans, a part of Cigna, is partnering with HCA East Florida to make the network accessible for approximately 40,000 Medicare Advantage members. 2. MedStar's network of Washington, D.C.-area hospitals are cutting ties with two insurance plans, leaving about 165,000 Medicaid beneficiaries without access to local providers ...
8/26/2021 Florida Cancer Specialists & Research Institute's ... a foundational tenant of the Oncology Care Model (OCM), a national innovative payment program launched by the Center for Medicare & Medicaid Innovation (CMMI) in July of 2016. VBC relies on shared accountability among providers, optimizing ... success and positive outcomes with Medicare and many commercial and Medicare Advantage payers. These relationships have yielded not only improved patient satisfaction, but significant shared savings and cost effectiveness, improved quality measures and patient outcomes ...
8/26/2021 Cortex Analytics‚Ñ¢ Set to Launch its Suite of Data Centric software Solutions at the RISE West Summit in Colorado Springs, CO August 31, 2021 PR Newswire ... proud to announce the introduction of its first suite of software solutions for participants in government-regulated insurance programs: managed Medicaid, the ACA Marketplaces, Medicare-Advantage, and Accountable Care Organizations (ACO), and supporting Market Vendors ... Quality performance and modeling specific to any line of business (Medicare Advantage with HEDIS and Stars, ACA with specific HEDIS, State specific Managed Medicaid quality initiatives) cortex CARE: provides a deep view into the member ...
8/25/2021 Florida Cancer Specialists & Research Institute's Integrated Value-Based Care Model Globe Newswire ... a foundational tenant of the Oncology Care Model (OCM), a national innovative payment program launched by the Center for Medicare & Medicaid Innovation (CMMI) in July of 2016. VBC relies on shared accountability among providers, optimizing ... success and positive outcomes with Medicare and many commercial and Medicare Advantage payers. These relationships have yielded not only improved patient satisfaction, but significant shared savings and cost effectiveness, improved quality measures and patient outcomes ...
8/25/2021 Florida Blue parent GuideWell to acquire Puerto Rico's BCBS carrier Healthcare Dive ... year and is subject to regulatory approvals. Dive Insight: One aim of the deal is to provide a more competitive Medicare Advantage product in Florida and Puerto Rico, executives outlined in a letter to other ... lives on the island and gives GuideWell a Medicare Advantage, Medicaid and commercial footprint on the island. In a letter to employees , Guidewell said the "transaction expands GuideWell's core insurance operations and will position us ...
8/25/2021 CMS Hints at Value-Based Program Consolidation, Gives Nod to I-SNP Success Centers for Medicare and Medicaid (CMS) Administrator Chiquita Brooks-LaSure noted higher participation in value-based payment models like Institutional Special Needs Plans (I-SNPs) during a recent discussion with HealthAffairs , but also hinted that ... payers seeing the model as an opportunity to expand their Medicare Advantage (MA) footprint, along with the skilled nursing industry. SNF operators have either participated in or launched their own I-SNPs, a specific type ...
8/24/2021 Unvaccinated hospitalizations cost US health system $2.3 billion in June & July | WTTE ... Medicaid Services (CMS) reports(/a) that Medicare fee-for-service COVID-19 hospitalizations average $24,033. Another study(/a) of Medicare fee-for-service enrollees found an average COVID-19 hospitalization cost $21,752. A FAIR Health analysis (/a)of private claims data including employer and private Medicare Advantage plans found that COVID-19 hospitalization costs ranged from $17,094 for people over age 70 to $24,012 for people in their 50s. Similarly ...
8/24/2021 Unvaccinated hospitalizations cost US health system $2.3 billion in June & July | WNWO ... Medicaid Services (CMS) reports that Medicare fee-for-service COVID-19 hospitalizations average $24,033. Another study of Medicare fee-for-service enrollees found an average COVID-19 hospitalization cost $21,752. A FAIR Health analysis of private claims data including employer and private Medicare Advantage plans found that COVID-19 hospitalization costs ranged from $17,094 for people over age 70 to $24,012 for people in their 50s. Similarly, our analysis of ...
8/24/2021 Unvaccinated hospitalizations cost US health system $2.3 billion in June & July | WEYI ... Medicaid Services (CMS) reports(/a) that Medicare fee-for-service COVID-19 hospitalizations average $24,033. Another study(/a) of Medicare fee-for-service enrollees found an average COVID-19 hospitalization cost $21,752. A FAIR Health analysis (/a)of private claims data including employer and private Medicare Advantage plans found that COVID-19 hospitalization costs ranged from $17,094 for people over age 70 to $24,012 for people in their 50s. Similarly ...
8/24/2021 Unvaccinated hospitalizations cost US health system $2.3 billion in June & July | WACH ... Medicaid Services (CMS) reports that Medicare fee-for-service COVID-19 hospitalizations average $24,033. Another study of Medicare fee-for-service enrollees found an average COVID-19 hospitalization cost $21,752. A FAIR Health analysis of private claims data including employer and private Medicare Advantage plans found that COVID-19 hospitalization costs ranged from $17,094 for people over age 70 to $24,012 for people in their 50s. Similarly, our analysis of ...
8/24/2021 Unvaccinated hospitalizations cost US health system $2.3 billion in June & July | WGFL ... Medicaid Services (CMS) reports that Medicare fee-for-service COVID-19 hospitalizations average $24,033. Another study of Medicare fee-for-service enrollees found an average COVID-19 hospitalization cost $21,752. A FAIR Health analysis of private claims data including employer and private Medicare Advantage plans found that COVID-19 hospitalization costs ranged from $17,094 for people over age 70 to $24,012 for people in their 50s. Similarly, our analysis of ...
8/24/2021 Unvaccinated hospitalizations cost US health system $2.3 billion in June & July | WPMI ... Medicaid Services (CMS) reports that Medicare fee-for-service COVID-19 hospitalizations average $24,033. Another study of Medicare fee-for-service enrollees found an average COVID-19 hospitalization cost $21,752. A FAIR Health analysis of private claims data including employer and private Medicare Advantage plans found that COVID-19 hospitalization costs ranged from $17,094 for people over age 70 to $24,012 for people in their 50s. Similarly, our analysis of ...
8/24/2021 Unvaccinated hospitalizations cost US health system $2.3 billion in June & July | WTVCFOX ... Medicaid Services (CMS) reports that Medicare fee-for-service COVID-19 hospitalizations average $24,033. Another study of Medicare fee-for-service enrollees found an average COVID-19 hospitalization cost $21,752. A FAIR Health analysis of private claims data including employer and private Medicare Advantage plans found that COVID-19 hospitalization costs ranged from $17,094 for people over age 70 to $24,012 for people in their 50s. Similarly, our analysis of ...
8/24/2021 Unvaccinated hospitalizations cost US health system $2.3 billion in June & July | KDBC ... Medicaid Services (CMS) reports that Medicare fee-for-service COVID-19 hospitalizations average $24,033. Another study of Medicare fee-for-service enrollees found an average COVID-19 hospitalization cost $21,752. A FAIR Health analysis of private claims data including employer and private Medicare Advantage plans found that COVID-19 hospitalization costs ranged from $17,094 for people over age 70 to $24,012 for people in their 50s. Similarly, our analysis of ...
8/24/2021 Unvaccinated hospitalizations cost US health system $2.3 billion in June & July | KSNV ... Medicaid Services (CMS) reports that Medicare fee-for-service COVID-19 hospitalizations average $24,033. Another study of Medicare fee-for-service enrollees found an average COVID-19 hospitalization cost $21,752. A FAIR Health analysis of private claims data including employer and private Medicare Advantage plans found that COVID-19 hospitalization costs ranged from $17,094 for people over age 70 to $24,012 for people in their 50s. Similarly, our analysis of ...