Expanded Medicare Benefits Could Drive Innovation in MA
Before the Senate adjourns for its annual summer recess, momentum was building at press time for what would be one of the most significant changes to the Medicare program since the addition of Part D. That would be ...
SCAN Will Tackle Homelessness With New Medical Group
Sachin Jain, M.D., is a longtime champion of treating certain social factors as medical issues. In his work as president of CareMore Health, a physician-led care delivery subsidiary of Anthem, Inc., he spearheaded e...
Part D Bid Will Fall in 2022, Reflecting Prior Years’ Trends
CMS’s annual release of Medicare Part D payment benchmarks and other bid-related information for the coming plan year tells pretty much the same story as in years past. The national average bid amount will continu...
Medicaid MCOs Mull RFP Pipeline, Redeterminations
Recognizing the continued uncertainty presented by the COVID-19 pandemic as the Delta variant rages across the country, select insurers reporting second-quarter 2021 earnings indicated that Medicaid enrollment helpe...
GAO Report Focuses on Medicare Advantage Disenrollments by Dying Beneficiaries
A new report from the Government Accountability Office reveals an alarming statistic that may prompt CMS to more closely monitor disenrollments: Medicare Advantage beneficiaries in their last year of life are more t...
As Out-of-Pocket Costs Rise, Medicare Part D Beneficiaries Have Limited Access to New Generic Drugs
Access to newly launched generic drugs is far more restricted for Medicare Part D beneficiaries compared to those with commercial coverage, according to a July report from the Association for Accessible Medicines (A...
News Briefs
✦ The U.S. Dept. of Justice has intervened in six False Claims Act complaints accusing Kaiser Permanente of submitting inaccurate diagnosis codes to receive inflated Medicare Advantage reimbursements. According to...
Regional MAOs Keep Watch on ‘Bad Actors’ in Marketing Space
While the COVID-19 pandemic complicated many smaller Medicare Advantage organizations’ efforts to connect with members during the Medicare Annual Election Period (AEP) last fall, reports of aggressive and misleadi...
Could Costco Be the Answer to Medicare Part D Restructuring?
A new analysis published in JAMA Internal Medicine suggests that Medicare “overspent” on certain popular generic drugs over a two-year period and could have saved billions of dollars if it had used a “streamli...
MA Insurers Plan for Return to In-Person Marketing This Fall
While the COVID-19 pandemic led to increased digital engagement with consumers during the last Annual Election Period (AEP), regional Medicare Advantage plans that thrive on community events and other in-person comm...