Medicare Advantage and Part D

From Medicare Advantage News - An indicator of the future direction of programs for Medicare-Medicaid dual eligibles could come soon when CMS will decide whether to approve a Michigan proposal that would keep behavioral health care separate from physical health care despite the goal of integrated care (MAN 11/21/13, p. 6). When Michigan selected eight health plans for its duals initiative last November, the state said it was in the process of “finalizing” its Memorandum of Understanding (MOU) with CMS. But more than four months later, there has been no MOU, and industry insiders tell MAN the major obstacle has been the separation of behavioral… Read more

From Medicare Advantage News - As the amount of time left before CMS issues its final 2015 Medicare Advantage and Part D payment notice and Call Letter dropped to less than a month, opponents of the cuts in the preliminary notice stepped up their efforts to seek big changes. And they got support from a bipartisan group of 40 senators as well as from a new study commissioned by the health insurance industry of the… Read more

Medicare Advantage & Part D Blog

By James Gutman - April 18, 2014
It used to be just an article of faith that UnitedHealth Group each quarter would start the health insurers’ earnings reporting cycle by posting earnings that not only were higher than in the year-ago period but also higher than expected. But when United kicked off the first-quarter reporting...
By James Gutman - April 11, 2014
If there is one word that virtually every queried actuary and consultant used to describe the pay-rate provisions of the final 2015 Medicare Advantage payment notice and Call Letter that CMS released April 7, it was “surprising.” While nearly everybody expected the agency to back off at least...
By James Gutman - April 4, 2014
Academic researchers often display a fondness for using several-years-old data to form conclusions about current issues. Often those data are the best available, and the conclusions aren’t affected by the age of the data. But this may not be the case when the subject deals with payments for...

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