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July 3, 2024

CMS Published Recalculated 2024 Medicare Advantage Star Scores

The Centers for Medicare and Medicaid Services (CMS) made public its revised Star scores for 2024 for Medicare Advantage (MA) plans today. The agency will have to fund an additional $1.3 billion after being rebuked by two courts on how it ignored regulations when setting guardrails for 2024. Actuarial firm Milliman says seventy-six MA contracts from 44 insurers (with almost 3.5 million members) saw increased Star scores.

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#medicareadvantage #stars #cms

https://www.modernhealthcare.com/medicare/medicare-advantage-star-ratings-recalculation-scan-elevance

Application Backlogs And Lagging Redeterminations In Medicaid

Healthcare policy advocates are reporting that more states might be falling behind in processing Medicaid applications due to all going on with redeterminations.  The Centers for Medicare and Medicaid Services (CMS) recently said nine states and the District of Columbia will go past the June 2024 deadline for processing redeterminations.

(Article may require a subscription.)

#medicaid #coverage #redeterminations

https://insidehealthpolicy.com/daily-news/latest-unwinding-data-show-states-falling-behind-medicaid-application-processing

Anxiety Over Healthcare Affordability Among Seniors

Seniors are increasingly worried about healthcare affordability due to rising costs in all areas of their lives. This is especially true among lower income seniors.  One in 7 report spending a quarter or more of their average monthly budget on healthcare.  About 44% spend between 10% and 24%.

#healthcare #medicare #coverage #costs

https://kffhealthnews.org/news/article/health-care-costs-older-americans-worry-election-issues/

HHS OIG To Probe Medicare Advantage Post-Acute Denials

The Department of Health and Human Services’ Office of Inspector General (HHS OIG) will audit Medicare Advantage (MA) denials of post-acute care requests in the prior authorization process. Interestingly, a new rule adopted by the Centers for Medicare and Medicaid Services (CMS) require MA plans to approve request for such services if a physician orders it.

#hhs #oig #medicareadvantage #priorauthorization

https://www.beckerspayer.com/payer/oig-to-probe-whether-medicare-advantage-plans-deny-post-acute-care.html

— Marc S. Ryan

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