Radar on Medicare Advantage

2021 Flex Benefits Show COVID Influence, Insurer Comfort

Last year, Medicare Advantage plans for the first time were able to extend a variety of non-primarily health-related items and services to their chronically ill beneficiaries, but insurer adoption of these benefits ...
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News Briefs

✦ President Joe Biden at press time was expected to name Chiquita Brooks-LaSure as the new CMS administrator, according to multiple news reports. Currently a managing director with Manatt Health, Brooks-LaSure i...
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Biden Kicks Off Presidency With Medicaid, Rebate Rule Actions

In a series of steps that were largely expected, the Biden administration in its early days moved to revisit policies approved by the prior administration that it views as weakening Medicaid and Affordable Care Act ...
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2021 Outlook: As Audits ‘Return to Normal,’ MAOs Could Face Tougher CMS

The Trump years were noticeably light on Medicare Parts C and D program enforcement — and 2020 in general was a departure from normal operations — but as CMS resumes program audits and other oversight activities...
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MA Organizations Can Expect Biden Administration to Revisit RADV Rule

Notably missing from the Trump administration’s late-term rulemaking blitz was a longstanding proposal regarding Risk Adjustment Data Validation (RADV) audits, but industry observers say it will likely be revisite...
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MA Plans’ Stars Innovations Prioritize Member Experience

In the ever-evolving world of star ratings, Medicare Advantage plans are at a unique crossroads where they must balance a bevy of changes to the measures used to determine their overall rating with managing members...
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MA, Cost, PACE, Demo, and Prescription Drug Plan Contract Enrollment Report (January 2021)

Preliminary figures from the 2021 Medicare Annual Election Period (AEP) indicate that total enrollment in Medicare Advantage plans surpassed 26.6 million as of the Jan. 1, 2021, payment date, which reflects enrollme...
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News Briefs

✦ Anthem, Inc. stands to acquire more than 267,000 Medicare Advantage members and over 305,000 Medicaid members in Puerto Rico through the planned purchase of MMM Healthcare, LLC from InnovaCare Health. The deal...
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Rate Notice Cites COVID Costs, Leaves Some Issues Unresolved

With less than a week to spare before the Jan. 20 inauguration of President Joe Biden, CMS on Jan. 15 followed up on its promise for an early release of the 2022 Medicare Advantage and Part D Rate Announcement, indi...
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Tenn. ‘Block Grant,’ Other Waiver Approvals May Be Moot

As part of its late-term rulemaking and waiver-approving blitz, the Trump administration on Jan. 8 cleared the way for Tennessee to become the first state to accept a fixed amount of federal funds in exchange for a ...
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