2+ hour, 48+ min ago   (85+ words) Analysis: MA insurers made 53 million prior authorization determinations in 2024American Hospital Association A KFF analysis released today found that Medicare Advantage insurers made nearly 53 million prior authorization determinations in 2024, an increase from 49.8 million in 2023. The report found that MA insurers fully…...

1+ day, 2+ hour ago   (204+ words) CMS proposes Medicare Advantage, Part D payment changes for CY 2027American Hospital Association The Centers for Medicare & Medicaid Services Jan. 26 released proposed changes to Medicare Advantage plan capitation rates and Part D payment policies for calendar year 2027, which the agency estimates…...

2+ day, 1+ hour ago   (106+ words) White paper explains use of mock claims for advanced explanation of benefits'American Hospital Association The AHA Jan. 26 released a white paper on addressing challenges in implementing an advanced explanation of benefits, which requires coordination among multiple providers, health plans and…...

2+ day, 9+ hour ago   (125+ words) The AHA Jan. 26 expressed support'and provided its perspective on certain provisions within the Centers for Medicare & Medicaid Services" proposed rule for policies governing the Medicare Advantage and Part D programs for contract year 2027. The AHA Jan. 26 expressed support and provided…...

1+ week, 2+ hour ago   (110+ words) CMS webinar to discuss 2026 hospital price transparency requirements'American Hospital Association The Centers for Medicare & Medicaid Services will host a webinar Feb. 11 at 2 p.m. ET on updated hospital price transparency requirements that were finalized in the hospital outpatient prospective payment system final…...

1+ week, 1+ day ago   (151+ words) The comment period for the Centers for Medicare & Medicaid Services' proposed rule for policies governing the Medicare Advantage and Part D programs for contract year 2027 ends Jan. 26. The comment period for the Centers for Medicare & Medicaid Services' proposed rule for…...

1+ week, 5+ day ago   (144+ words) MedPAC recommends Medicare 2027 payment updates to Congress for inpatient, outpatient services'American Hospital Association The Medicare Payment Advisory Commission Jan. 15 voted to recommend that Congress update Medicare payment rates for hospital inpatient and outpatient services by the current law amount for…...

1+ week, 5+ day ago   (214+ words) Every year tens of millions of Americans dig deep into their pocketbooks to pay for health insurance plans that will cover both preventive and necessary care for individuals and families. The premiums are paid in good faith, as consumers count…...

3+ week, 9+ hour ago   (101+ words) The Centers for Medicare & Medicaid Services has implemented an online form for providers to submit complaints regarding Medicare Advantage plans. The Centers for Medicare & Medicaid Services has implemented an online form for providers to submit complaints regarding Medicare Advantage plans....

1+ mon, 1+ week ago   (120+ words) The Centers for Medicare & Medicaid Services Dec. 19 issued two proposed rules for implementing alternative drug pricing models." The Centers for Medicare & Medicaid Services Dec. 19 issued two proposed rules for implementing alternative drug pricing models. The first proposed rule would implement…...