Payer

Providers, nursing home representatives and advocates for patients say Medicare Advantage plans are sending enrollees home from skilled nursing and rehabilitation centers before they are healthy enough to leave, according to an Oct. 3 Kaiser Health News and Fortune report. 

Moda Health, a Portland, Ore.-based insurer with 400,000 members, is offering plans in Idaho for 2023, the company said Oct. 3. 

The New York Medicaid Inspector General's Office recovered and saved a combined $3.2 billion in 2021, up from $3 billion in 2020, according to the office's 2021 report.  

Enrollment in employer-sponsored health insurance declined during the COVID-19 pandemic, disproportionately affecting women and employees of small businesses, a new study published in JAMA Network Open found. 

Audits of BlueCross BlueShield of Tennessee and Inter Valley Health Plan found the organizations' Medicare Advantage plans received millions in overpayments as a result of diagnosis codes submitted to CMS that were not backed up by medical records. 

From premium decreases and study findings to star ratings and plan expansions, here are 14 Medicare Advantage stories Becker's has reported since Sept. 12. 

CMS' Value-Based Insurance Design program for Medicare Advantage plans is growing for 2023, expanding to 52 participating organizations, the agency said Sept. 29. 

A group of senators is asking CMS to clarify whether Medicaid funds can be used to pay for crisis stabilization in facilities with more than 16 beds.

The first drugs negotiated by Medicare are likely to be blood thinners, diabetes treatments and cancer drugs, physicians predicted in a Sept. 30 article for Health Affairs.

Centene and Florida Blue are among the largest donors to Florida's disaster fund support recovery from Hurricane Ian, according to a news release from the state's first lady, Casey DeSantis.