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Medicare Advantage

Latest Headlines

Latest Headlines

Reimbursement system is broken, insurance CEO says

The health insurance payment system is broken and the Affordable Care Act, which was supposed to lower costs, is actually contributing to the problem, MVP Health Care CEO Denise Gonick, told the  Albany Business Review. 

Medicare Advantage roundup: UnitedHealth, Humana, MVP Health Care make changes

There have been a lot of changes to Medicare Advantage plans of late--UnitedHealth dropped providers in Alabama, Humana lost a big provider contract and MVP Health Care is discontinuing two of its plans.

4 complaints providers have with Medicare Advantage

Medicare Advantage plans are widely popular among Medicare-eligible consumers, but not everyone is fond of them. Many providers actually dislike the Medicare Advantage program and, therefore, are reluctant to contract with Medicare Advantage insurers.

Some states want more authority over Medicare Advantage

Some state officials want more regulatory authority over Medicare Advantage plans. Right now, state regulators can't impose sanctions on Medicare Advantage plans; only the Centers for Medicare & Medicaid Services has that power.

Medicare spending slowdown could put brakes on Medicare reform

Medicare spending will slow down over the next decade--and although  this bodes well for the federal budget it could also slow down Medicare reform, notes a  post  in  the Morning Consult.

Republican lawmakers blast Medicare Advantage cuts

Republicans claim the Obama administration is "masking" Medicare Advatage cuts now to avoid making voters angry in an election year, according to The Hill.

Why Medicare Advantage should function like exchanges

If Medicare Advantage plans had to compete for members like plans sold on the health insurance exchanges, insurers could provide high value at lower costs, reported the New York Times.

New standards could expand provider networks

As health insurers' provider networks get more narrow, many states are adopting standards to ease consumer concerns about limited selections of doctors and hospitals, reports The New York Times.

Medicare, Part D plans must scrutinize pharmacy benefit manager practices, relationships

Insurers in Medicare Advantage and Part D should evaluate their practices and relationships with pharmacy benefit managers to ensure better quality and member experience.

CMS wants more authority to recover Medicare Advantage overpayments

The Centers for Medicare & Medicaid Services wants to establish a formal process that allows it to use a payment offset system to handle disputes with Medicare Advantage insurers about potential payment errors.