Medicare Enrollment Guidance for HR Managing Employees Over 65
Key Medicare enrollment rules for HR managing employees over 65 with employer health benefits. Guidance on timing, documentation, and regulatory compliance to avoid coverage gaps.
Medicare Quality Programs Under Scrutiny: Calls for Supportive Reform
Medicare's pay-for-performance programs face criticism for inefficacy and inequity. Experts advocate shifting to supportive models rewarding incremental improvement and incorporating patient-reported outcomes to enhance quality care.
CMS Launches AI-Driven Prior Authorization Pilot for Traditional Medicare in Washington
CMS to start AI-driven prior authorization pilot for traditional Medicare in Washington and five other states in 2026, targeting low-value procedures to reduce waste and improve compliance while maintaining clinician oversight.
Algorithms Enhance Fairness in Medicare Advantage Risk Adjustment Payments
New algorithmic approaches improve fairness in Medicare Advantage payment models, promoting equitable spending for minority beneficiaries without reducing predictive accuracy.
Birmingham VA Health Care System Achieves 5-Star CMS Rating in 2025
The Birmingham VA Health Care System earned a 5-star rating from CMS in 2025, ranking among the top medical centers nationwide for Veteran health care quality and safety.
CMS Extends and Enhances AHEAD Model to Advance Cost Control and Prevention
CMS extends the AHEAD Model to 2035, introducing payment reforms and transparency to improve Medicare cost control, prevention, and population health outcomes.
Medicare Advantage's Growth Shifts Coverage Landscape for Retirees
Explore how Medicare Advantage's growth reshapes retiree coverage, employer health benefits, and taxpayer costs amid evolving Medicare policy and enrollment trends.
2026 Social Security COLA Rise Eroded by Medicare Premium Increases
Social Security benefits in 2026 will increase by 2.7%, but rising Medicare Part B and D premiums will significantly reduce the net gain for retirees, highlighting challenges in healthcare cost inflation and COLA calculations.
AdvaMed Urges CMS to Reconsider Medicare Competitive Bidding for Medical Equipment
AdvaMed raises patient safety and legal concerns over CMS's proposed Medicare competitive bidding programme restart for durable medical equipment and devices.
Medicare Coverage Limits on Routine Dental and Sensory Care for Seniors
Medicare covers essential dental and sensory treatments for seniors but excludes routine check-ups and preventive care, impacting senior health insurance planning.