medicare Archives - Page 14 of 14 - DR News

Medicare Advantage Meeting Sparks Controversy Over Cost and Patient Selection

WASHINGTON, D.C. – The Medicare Payment Advisory Commission (MedPAC) recently convened to discuss its annual reports on the status of the Medicare program, including the controversial findings of its report on Medicare Advantage (MA). The discussion became heated as the commission clashed over the assessment of MA’s costliness and its implications for patients’ health and healthcare financing. MedPAC’s MA status report revealed that the program’s payments were higher compared to the traditional fee-for-service (FFS) model, …

Medicare Overpayments: Warren and Jayapal Push for Aggressive Plan Changes

Washington, D.C. – The Biden administration is preparing to establish new regulations for next year’s Medicare Advantage plans, with Democratic lawmakers proposing significant changes to the functioning of these insurance plans. Sen. Elizabeth Warren (D-Mass.) and Rep. Pramila Jayapal (D-Wash.) penned a letter to Medicare Administrator Chiquita Brooks-LaSure, urging the government to take decisive steps to address the estimated $100 billion in annual overpayments and questionable quality bonuses received by Medicare Advantage insurers. They argue …

Medicare Advantage Enrollment: Exploring the Pitfalls and Risks

SEATTLE, Washington – When Richard Timmins attended a Medicare informational seminar in 2016, he was attracted to the promise of broader and less expensive coverage offered by Medicare Advantage plans. The plans, largely funded by the government but administered by private insurance companies, seemed like a practical choice at the time for the 76-year-old retired veterinarian. However, after noticing a lesion on his earlobe three years ago, Timmins’ experience with his Premera Blue Cross Medicare …

Medicare Business Faces Grim Outlook for the Year Ahead

Los Angeles, CA – Medicare business is expected to face tough times ahead with the effects of the pandemic lingering for the next year or more. As the healthcare industry continues to grapple with the challenges brought on by the pandemic, Medicare providers are bracing themselves for a difficult period. One of the major concerns for the Medicare business is the decrease in patient visits and elective surgeries, which are significant sources of revenue for …

TRICARE For Life: Essential Tips for Getting Care with Medicare Coverage

Falls Church, Va. – For those who are either new to TRICARE For Life (TFL) or have been enrolled for years, there may be questions about navigating healthcare with TFL. TFL provides wraparound coverage for military retirees and their eligible family members with Medicare Part A and Part B. This means that Medicare is the primary health coverage when a person has TFL. Understanding how Medicare coverage works is essential in order to avoid unexpected …

CMS Must Expand Obesity Care for Seniors in Medicare Part D

Washington D.C. – Between 2017 and 2020, nearly half of all Americans were living with obesity, a complex and chronic disease that has serious health implications. However, the Centers for Medicare and Medicare Services (CMS) has come under scrutiny for not providing coverage for comprehensive obesity care, including anti-obesity medications in Medicare Part D. This has led to a growing call for expanded obesity care and access to effective treatments for this widespread health issue. …

Ships Can Help With Your Medicare Problems

Medicare can be a complicated system. A mistake when signing up could lead to lifelong penalties or coverage gaps, and people who lose their jobs after 65 have an extra layer of complexity. Every Medicare beneficiary can select a Medicare Part D or Medicare Advantage plan during open enrollment each year. The plan you choose could significantly impact your out-of-pocket expenses. Many low-income people aren’t aware that they are eligible for extra assistance to pay for Medicare drugs. You can appeal and fight back if your medication or care is denied. All of these complicated Medicare issues can be handled by your State Health Insurance Assistance Program or SHIP.

Delaware Working Group Recommends Changes to State Retiree Healthcare Benefits, Including Medicare Advantage Plan Elimination

Dover, Delaware – The Retiree Healthcare Benefits Advisory Subcommittee has recommended that Delaware no longer consider a Medicare Advantage plan for state retiree healthcare benefits. The working group was established by the state’s General Assembly a year ago to address concerns about healthcare benefits for current and retired state workers and the growing unfunded liability for those benefits. This recommendation comes after a proposed transition to a Delaware-specific Medicare Advantage plan faced strong opposition from …

Medicare Fraud Scheme Lands Clarence Center Man in Prison for 7.5 Years

A Clarence Center man has been sentenced to 7 ½ years in federal prison for his involvement in a scheme that led to $29 million in false Medicare claims. Jeffrey Brooks, 40, pleaded guilty to one count of conspiracy to commit health care fraud and has been ordered to pay more than $15.2 million in restitution to Medicare and the Civilian Health and Medical Program of the Department of Veterans Affairs. According to the U.S. …