Tagged with Medicare Advantage

Anthem Announces Fee Schedule Changes

Anthem Blue Cross and Blue Shield (Anthem) recently notified members of the upcoming changes to its Anthem Plan Fee Schedules, scheduled to take place July 1.

CMS Releases 2020 Medicare Advantage and Part D Rates

On April 1, CMS released its finalized payment and policy changes for Medicare Advantage (MA) and Medicare Part D plans for the 2020 coverage year. CMS states the final updates will continue to maximize competition among Medicare Advantage and Part D plans, as well as include important actions to address the nation’s opioid crisis.

CMS Introduces New Cost Comparison Tool

In an effort to improve healthcare price transparency, CMS launched a tool that allows consumers to compare Medicare payments and copayments for certain procedures that are performed in both hospital outpatient departments and ambulatory surgical centers.

Humana Updated Claim Payment Policies

Humana recently published new updates to its claim payment policy for pass-through billing as well as its policy for telehealth and telemedicine.

HHS Advances Payment Model to Lower Drug Costs for Patients

HHS has announced a new International Pricing Index (IPI) payment model to reduce what consumers in the United States pay for prescription drugs. Under the new model, Medicare’s payments for select physician-administered drugs would shift to a level more closely aligned with prices in other countries.

CMS Announces New Streamlined User Experience for Medicare Beneficiaries

CMS, on October 1, announced a multi-year initiative that will empower patients and update Medicare resources to meet beneficiaries’ expectation of a more personalized customer experience. The eMedicare initiative will modernize the way beneficiaries get information about Medicare and create new ways to help them make the best decisions for themselves and their families.

Humana Claim Processing Edits

Humana has released several claims processing edits, including updates to Outpatient Prospective Payment System (OPPS), Modifiers 96 and 97, HCPCS Drugs & Biologicals, and other policies.

MedPAC Releases 2018 Report

The Medicare Payment Advisory Commission (MedPAC) has released its March 2018 Report to Congress on Medicare payment policy, detailing its payment update recommendations to Congress, which the Commissioners voted on in January.

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