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Analysis: MA insurers made 53 million prior authorization determinations in 2024
A KFF analysis released Jan. 28 found that Medicare Advantage insurers made nearly 53 million prior authorization determinations in 2024, an increase from 49.8 million in 2023.
CMS proposes Medicare Advantage, Part D payment changes for CY 2027
The Centers for Medicare & Medicaid Services Jan. 26 released proposed changes to Medicare Advantage plan capitation rates and Part D payment policies for calendar year 2027, which the agency estimates will result in a net average year-over-year increase of 0.09% in MA plan payments, or $700 million.
AHA comments on 2027 Medicare Advantage, Part D policy proposals
The AHA Jan. 26 expressed support and provided its perspective on certain provisions within the Centers for Medicare & Medicaid Services’ proposed rule for policies governing the Medicare Advantage and Part D programs for contract year 2027.
Comment deadline nears for 2027 Medicare Advantage, Part D policy proposals
The comment period for the Centers for Medicare & Medicaid Services' proposed rule for policies governing the Medicare Advantage and Part D programs for contract year 2027 ends Jan. 26.
MedPAC recommends Medicare 2027 payment updates to Congress for inpatient, outpatient services
The Medicare Payment Advisory Commission Jan. 15 voted to recommend that Congress update Medicare payment rates for hospital inpatient and outpatient services by the current law amount for 2027 and reiterated its recommendation to distribute an additional $1 billion to safety-net hospitals by transitioning to a Medicare safety-net index policy.
UHG launches pilot program for rural hospitals in 4 states to cut MA payment collection times by half
UnitedHealth Group announced Jan. 14 that it launched a six-month pilot program to reduce Medicare Advantage payment processing times by half for rural hospitals in four states.
Senate report says UHG used ‘aggressive strategies’ to increase MA payments
A Senate Judiciary Committee report released Jan. 12 found that UnitedHealth Group used “aggressive strategies” to maximize its Medicare Advantage risk-adjustment scores and collect higher payments from diagnoses of MA enrollees.
AHA urges MedPAC to recommend higher payment updates ahead of January meeting
The AHA Jan. 9 urged the Medicare Payment Advisory Commission to consider, during its next meeting Jan. 15-16, higher payment updates for the inpatient and outpatient prospective payment systems than those discussed in December and to examine Medicare Advantage’s role in access to care and provider financial stability.
CMS releases form for submitting provider complaints on Medicare Advantage plans
The Centers for Medicare & Medicaid Services has implemented an online form for providers to submit complaints regarding Medicare Advantage plans.
CMS announces pilot on MA service level data collection for initial determinations, appeals
The Centers for Medicare & Medicaid Services released a memo Dec. 16 announcing the agency’s intent to conduct a voluntary pilot in 2026, called the Service Level Data Collection for Initial Determinations and Appeals.