The Centers for Medicare and Medicaid (CMS) have announced enforcement actions against two Medicare Advantage Program for All-Inclusive Care for the Elderly (PACE) contractors. Both Silver Star Health Network in Lubbock, TX, and Alexian Brothers Community Services in St. Louis, MO, received civil monetary penalties of $25,000 each for non-compliance of Medicare regulations. Formal letters notifying the Medicare Advantage Plans of the penalty were sent out August 1, 2013.
Medicare
Posts focusing on Medicare Parts A, B, C and D, Medicare Advantage, Supplements, changes in benefits, enrollment.
Are Sacramento Medicare provider charges worthless?
The Centers for Medicare and Medicaid released the cost they pay for the top 100 hospital treatments for beneficiaries of Medicare across the country and the data presentation is virtually worthless to the average human being. The Charge master data set was successful in highlighting the complex and dysfunctional system we have in the U.S. for tracking and paying for health care.
CMS sanctions SmartD Rx PDP
CMS cited numerous failures on the part of SmartD Rx to properly handle member’s prescription drug and enrollment transactions.
Anthem Blue Cross roots of healthcare cost increases
The larger point of Anthem’s discussion is that rising health care costs have several roots. There is no one culprit that is driving costs.
Medicare Advantage Special Enrollment for Poor Performers
Medicare special election or enrollment notice for individual enrolled in a 3 start rated Medicare Advantage plan can switch to a higher rated plan, 2013
Washington rewards private Medicare Advantage, cuts Medicare cancer treatment
The contradictory nature of Washington lawmakers was on full display this past week as they lobbied the Centers for Medicare and Medicaid (CMS) not to cut reimbursements to privately run Medicare Advantage plans while allowing the budget sequester to curtail funding for Medicare cancer patients.
Are Medicare Advantage Plans Threatened by Reform?
It was an urgent plea by an insurance company that I had to act now to save Medicare Advantage Plans.
Obama targets Medicare Fraud, nets $7.90
Possibly written by someone who has watched too many war movies, the press release is sprinkled with military type adjectives and titles to reinforce President Obama’s assault on fraud.
Medicare Sanctions CVS/Caremark SilverScript Part D Plan
On January 15th, Medicare imposed an immediate sanction on SilverScripts Part D Prescription drug plans, available through CVS/Caremark, from marketing or selling any new drug plans because of massive failures to properly handle prescription drug claims of new members.
Senior ban on ladder climbing could save Medicare $ millions
A recent study entitled Reducing Medicare Expenditures advocates that seniors should be banned from owning ladders, step stools and living in two-story homes with stairs.