Tag: Medicare

MemorialCare Offers 2026 Medicare Advantage Plan Education Sessions in Long Beach

Long Beach seniors can learn about 2026 Medicare Advantage Plan updates and enrollment options during MemorialCare's in-person and virtual sessions before the December 7 enrollment deadline.

CMS Proposes 2027 Medicare Advantage Rule; Drug Price Negotiations Advance

Summary of recent CMS proposals affecting 2027 Medicare Advantage and Part D, plus updates on Medicare drug price negotiations impacting federal health programs.

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.

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.