CMS Issues Part One of MA Final Rule

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The Centers for Medicare & Medicaid Services (CMS) has issued the final rule: Contract Year 2021 Policy and Technical Changes to the Medicare Program, Medicare Prescription Benefit Program, and Medicare Cost Plan Program. In response to the COVID-19 pandemic and to give the MA plans adequate time to implement the changes, CMS is issuing the […]

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CMS Announces Hospice MA-VBID Model Webinar Series

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In January 2019, the Centers for Medicare & Medicaid Services (CMS) announced plans to test inclusion of the Medicare hospice benefit under the Medicare Advantage (MA) benefit package through its ongoing Value-Based Insurance Design (VBID) MA demonstration program.  Additional details around the model were released in late December as part of CMS’ Request for Applications […]

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CMS Outlines Planned Payment for Hospice Medicare Advantage Coverage under VBID Test

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In CY2021 the Centers for Medicare & Medicaid Services (CMS) plans to test coverage of hospice as part of the Medicare Advantage (MA) benefit package through its ongoing Value-Based Insurance Design (VBID) model. (See this NAHC Report article for more information.)  A December 2019 Request for Applications (RFA) outlining of the model, participating plans must […]

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CMS Issues Proposals for Medicare Advantage Plans

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The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule titled: Medicare and Medicaid Programs; Contract Year 2021 and 2022 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicaid Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly. Also released, is Part […]

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CMS Releases Long-awaited Details on MA/Hospice Carve-in

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Demonstration Planned for CY2021 Late December 19, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a Request for Applications (RFA) for the Value-Based Insurance Design (VBID) Model Incorporation of the Medicare Hospice Benefit into Medicare Advantage (MA), through which it is seeking participation by MA plans.  Eligible MA plans in all states and […]

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Annual Update to Threshold Amounts for Medicare Appeals

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The annual adjustment in the amount in controversy (AIC) threshold amounts for Administrative Law Judge (ALJ) hearings and judicial review under the Medicare appeals process has been updated. The adjustment to the AIC threshold amounts will be effective for requests for ALJ hearings and judicial review filed on or after January 1, 2020. The calendar […]

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Executive Order Provides Limited Detail but Presages Policies to Advance Medicare Advantage, Other Changes

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On October 3, President Donald Trump signed an Executive Order (EO) on “Protecting and Improving Medicare for Our Nation’s Seniors” expressing disapproval of efforts by some in Congress to encourage “Medicare for All” policies and, instead, to promote health initiatives endorsed by the Administration.  While the EO does not, of itself, directly change any existing […]

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Congress Debates Bill to Automate Prior Authorization in Medicare Advantage Plans

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Recently the House of Representatives’ Small Business Committee convened for a hearing on utilization management and barriers to care in small medical practices. In particular this hearing focused on the application of prior authorization within Medicare Advantage (MA) plans and the associated challenges faced by patients and providers of services due to prior authorization requirements. […]

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NAHC Webinar: Why Medicare Advantage Should be on the Hospice Radar Screen

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The National Association for Home Care & Hospice (NAHC) will present a new webinar, Why Medicare Advantage Should be on the Hospice Radar Screen, Part III. The webinar will take place on Wednesday, September 11, 2019 from 2:00 PM to 3:00 PM Eastern Time. REGISTER NOW! Recent growth in Medicare Advantage penetration, and rules that […]

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How Home Health Agencies Can Succeed with Medicare Advantage

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The National Association for Home Care & Hospice (NAHC) will present a new educational webinar in the HHFMA Webinar Series entitled “Success Under Medicare Advantage for Home Health, Part 2.” This webinar, which is free for NAHC members and only $100 for non-members, will air live from 2:00 PM to 3:00 PM Eastern on Thursday, […]

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Understand What Medicare Advantage Means for Your Agency

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The National Association for Home Care & Hospice (NAHC) will present a critical new webinar, Medicare Advantage Overview for Home Health, to explain what Medicare Advantage is and what it means for your home health agency. This webinar from the Home Health Financial Management Association (HHFMA) will be live from 2:00 PM to 3:30 PM […]

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