Voices of Medicare | Medicare Advantage Network Inadequacy We recently heard from a Medicare Advantage (MA) enrollee from the Dallas-Forth Worth metropolitan area who went several months without seeing a gastroenterologist due to Cigna’s failure … [Read more...] about CMA Alert | July 7, 2022
Search Results for: NOTICE
Voices of Medicare | Medicare Advantage Network Inadequacy
We recently heard from a Medicare Advantage (MA) enrollee from the Dallas-Forth Worth metropolitan area who went several months without seeing a gastroenterologist due to Cigna’s failure to contract with such specialists. She received no prior notice … [Read more...] about Voices of Medicare | Medicare Advantage Network Inadequacy
CMA Alert | June 23, 2022
Supreme Court Decision Places End-Stage Renal Disease Patients at Risk In a decision that may place people with end-stage renal disease (ESRD) at risk, the Supreme Court held this week that an employer-sponsored group health plan can restrict … [Read more...] about CMA Alert | June 23, 2022
Nursing Home Staffing at All-Time Low; Which Solutions Will Help?
During the coronavirus pandemic and as of January 2022, nursing facilities lost 238,000 staff members, 15% of their total workforce.[1] According to a survey by the trade association American Health Care Association (AHCA), more than 87% of … [Read more...] about Nursing Home Staffing at All-Time Low; Which Solutions Will Help?
Insurance Industry v. Provider Response to OIG Report re: MA Denials
The recently issued HHS Office of Inspector General report focusing on Medicare Advantage plan denials titled “Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary … [Read more...] about Insurance Industry v. Provider Response to OIG Report re: MA Denials
CMA Alert | April 21, 2022
Members of Congress Send Letter to CMS Urging Agency to Address Medicare Advantage Overpayments On April 20, 2022, 19 members of the House and Senate sent a letter to Centers for Medicare & Medicaid (CMS) Administrator Chiquita Brooks-LaSure … [Read more...] about CMA Alert | April 21, 2022
When Artificial Intelligence in Medicare Advantage Impedes Access to Care: A Case Study
The use of artificial intelligence (AI) in healthcare is capturing headlines as a potential tool to streamline operations and predict patient needs for favorable health outcomes, among other things.[1] The Center for Medicare Advocacy, however, has … [Read more...] about When Artificial Intelligence in Medicare Advantage Impedes Access to Care: A Case Study
CMA Alert | April 14, 2022
Federal Government Must Enact and Enforce Nurse Staffing Standards for Nursing Facilities At a roundtable discussion with HHS Secretary Xavier Becerra on March 30, which the Center for Medicare Advocacy attended as one of seven invitees, Mark … [Read more...] about CMA Alert | April 14, 2022
CMS Begins Process of Setting Mandatory Nurse Staffing Standards for Nursing Facilities
As part of the annual proposed rule updating Medicare Part A payments to skilled nursing facilities (SNFs),[1] the Centers for Medicare & Medicaid Services (CMS) is beginning the process of establishing nurse staffing standards for facilities, as … [Read more...] about CMS Begins Process of Setting Mandatory Nurse Staffing Standards for Nursing Facilities
Federal Government Must Enact and Enforce Nurse Staffing Standards for Nursing Facilities
At a roundtable discussion with HHS Secretary Xavier Becerra on March 30, which the Center for Medicare Advocacy attended as one of seven invitees, Mark Parkinson, President and CEO of the American Health Care Association, the trade association of … [Read more...] about Federal Government Must Enact and Enforce Nurse Staffing Standards for Nursing Facilities