The Centers for Medicare & Medicaid Services (CMS) has agreed to release the audits of 90 Medicare Advantage (MA) plans conducted between 2011 and 2013. The records are expected to detail more than $600 million in MA overpayments due to “upcoding,” plan abuses of patient categorization rules. Access to this […]
Research published this month shows that over one million adults rationed insulin doses in the past year due to the drug’s high costs. These cutbacks took various forms, including delaying purchase, skimping on doses, or skipping the medication altogether. In the United States, insulin prices far outstrip costs in other […]
This week, the Commonwealth Fund released an issue brief on how and why people with Medicare choose between Original Medicare (OM) and Medicare Advantage (MA). The issue brief discusses the tradeoffs between the options and how beneficiaries tend to rate them. Those who choose OM have access to any provider […]
This week, the Kaiser Family Foundation (KFF) released a Medicare Part D fact sheet providing an overview of plan availability, enrollment, and costs. About 49 million people with Medicare are enrolled in Part D plans. Next year, there will be 801 stand-alone prescription drug plans (PDPs) to choose from, a 5% […]
Fall is always a busy time for reviewing and changing health coverage. But this year’s open enrollment periods for Medicare and the Affordable Care Act (ACA) have some surprises in store. Medicare’s Annual Election Period (AEP) runs from October 15 to December 7. Though many beneficiaries don’t compare options, we […]
A new Centers for Medicare & Medicaid Services (CMS) fact sheet outlines key Inflation Reduction Act (IRA) Medicare changes and effective dates. Key prescription drug affordability highlights include: 2023 — Insulin will be limited to $35 for a month’s supply. This takes effect January 1 for insulin covered under Part […]
Medicare Rights Advocacy and Education Medicare Rights reviews integrated appeals efforts in New York On September 19, as part of an ongoing series examining Medicare and Medicaid integration, Health Affairs Forefront published an article from the Medicare Rights Center. Titled Integrated Appeals Are Essential, But Challenges Remain, it highlights the need for states to integrate […]
In advance of the upcoming Medicare Open Enrollment period, which begins on October 15, the Biden administration announced a lower standard monthly premium and deductible for Medicare Part B enrollees. In addition, the administration announced slightly lower average Medicare Advantage and Part D premium rates for 2023. The standard monthly […]
According to a new U.S. Department of Health and Human Services (HHS) analysis, in 2022, the list prices of over 1,200 prescription drugs increased by an average of 32%—far outpacing the year’s 8.5% inflation rate. The report underscores the importance of the Inflation Reduction Act (IRA) provisions that aim to […]
