House Extends Medicare Hospital-Level Care at Home Program Through 2030
The U.S. House passes H.R. 4313 to extend the Medicare Acute Hospital Care at Home program through 2030, enhancing reimbursement for hospital-level care provided at home.
Medicare Advantage to Traditional Medicare Switch Linked to Increased Mental Health Visits and Provider Shifts
Study shows Medicare Advantage beneficiaries with mental health conditions increase mental health visits and nurse practitioner use after switching to traditional Medicare, highlighting network access issues in MA plans.
Higher Quality and Lower Utilization in At-Risk Medicare Advantage for Dual-Eligible Beneficiaries
Analysis reveals at-risk Medicare Advantage models deliver better quality and lower utilization for dual-eligible beneficiaries versus traditional and fee-for-service Medicare, supporting CMS care accountability goals.
Illinois Physician Charged with Over $1M Medicaid and Medicare Fraud
Illinois physician faces multiple felony charges for stealing over $1 million in Medicaid and Medicare payments through fraudulent billing practices involving unlicensed medical services.
TEAM Model Poised to Reshape Post-Acute Care with Varying Provider Readiness
Skilled nursing and hospital readiness varies as the CMS-initiated TEAM bundled payment model launches in 2026, impacting post-acute care coordination, financial risk, and value-based contracting in U.S. healthcare.
IRS Filing Status Impacts Medicare Premiums, Not Eligibility
Understand how IRS tax filing status affects Medicare Part B and D premiums through IRMAA income thresholds, with tips on enrollment timing and employer coverage.
AI-Driven Prior Authorization Pilot Launches in Six States for Medicare
Beginning January 2026, six states will pilot an AI-driven prior authorization program in traditional Medicare to target fraud and waste, sparking industry concerns over increased claim denials and access delays.
CMS 2026 Medicare Outpatient Payments Rise 2.6%, Site-Neutral Cuts Take Effect
CMS finalizes 2026 Medicare outpatient payment rule with 2.6% increase, site-neutral payment cuts, and elimination of inpatient-only list impacting hospitals and ASCs.
Medicare Telehealth Use Substitutes Rather than Adds to Care, Analysis Finds
New analysis of 1.67M Medicare beneficiaries shows telehealth primarily substitutes in-person visits, stabilizing overall utilization. Key insights for policy and healthcare delivery.
Everything Senior Insurance Supports Utah Medicare Clients Through AEP 2025
Everything Senior Insurance provides Utah seniors with expert Medicare plan guidance and year-round support, highlighting key changes during the 2025 Medicare Annual Enrollment Period.