Tag Archives: Plans

HHS to audit plans for compliance with HIPAA transactions

The federal agency responsible for regulations governing standardization of electronic transactions and data accessibility for consumers is ramping up adherence efforts. The Department of Health and Human Services is launched a pilot auditing program, starting with health plans and claims clearinghouses, to ensure industry stakeholders are complying with HIPAA-related rules governing electronic healthcare transactions. In… Read More »

Narrow networks in Medicare Advantage plans refuted in new study

The share of Medicare Advantage primary care physician plans with broad networks has increased and enrollment in these plans is growing even more, according to analysis published this month in Health Affairs. The study, which claims to be the first longitudinal and national analysis of MA primary care physician networks, used a claims-based method for… Read More »

CMS rule gives Medicare Advantage plans an edge over traditional Medicare

The Centers for Medicare and Medicaid Services today finalized payment updates to Medicare Advantage and Part D plans for 2020. MA rates increase 2.53 percent. This includes the phasing-in of a risk adjustment model that takes into account the number of chronic conditions a person has, according to CMS Administrator Seema Verma. CMS originally had… Read More »