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Medicare
Former HealthSun Executive Charged for Role in Medicare Fraud Scheme
Recently, the United States Department of Justice (DOJ) filed charges against Kenia Valle Boza, a former HealthSun Health Plans…
CMS Announces GUIDE Model, Focused on Dementia Care and Management
The US Centers for Medicare & Medicaid Services (CMS) recently announced a new, voluntary and nationwide test model. The model…
AARP Report Highlights the Increase in Medicare Part D Drug List Price
A new report from AARP found that the 25 drugs that accounted for the highest Medicare Part D spending in 2021 more than tripled…
CMS Released Draft Guidance on Medicare Out of Pocket Copays
On August 21, 2023, the Centers for Medicare & Medicaid Services (CMS) released draft guidance on a new program that will…
CMS Announces New Slate of Reduced Coinsurance Drugs for Q4 2023
Recently, the Centers for Medicare and Medicaid Services (CMS) announced a third set of Medicare Part B prescription drugs that…
CMS Issues Proposed Changes to Medicare Physician Fee Schedule and Part B…
On July 13, 2023, CMS issued a proposed rule that identifies and seeks public comments on a broad array of proposed changes to the…
Connecticut Hospitals Reach $560K False Claims Act Settlement
Recently, Yale New Haven Health Services Corp. and Northeast Medical Group, Inc., agreed to pay more than half a million dollars…
Senate Subcommittee on Investigations to Review Delays and Denials in the…
The Senate Permanent Subcommittee on Investigations recently held a hearing on delays and denials of care in the Medicare…
CMS Set to Scrutinize Medicare Advantage Marketing
In a May 10 letter to Medicare Advantage organizations and prescription drug plans, CMS said it will more closely scrutinize more…
CMS Issues Final Rule, Making changes to MA and Part D
In April, the Centers for Medicare & Medicaid Services (CMS) issued a Final Rule regarding the Medicare Advantage (MA) and…