CMS issues final MLR rule for Medicare advantage and Part D programs *

USA - May 21 2013
Last week, CMS published a final rule implementing the ACA's medical loss ratio ("MLR") requirements that will apply to the Medicare Advantage (Part…

Co-authors: Susan W. Berson.

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Despite the ACA’s cost-saving measures, modest increases in health care costs unlikely to continue *

USA - April 24 2013
Earlier this week, the Kaiser Family Foundation and the Altarum Institute's Center for Sustainable Health Spending published an analysis of the…

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2014 Final Call letter: CMS raises Medicare advantage rates but foreshadows other significant program changes *

USA - April 16 2013
After receiving many comments on its Draft Call Letter, CMS published its Contract Year 2014 Final Call Letter on April 1, 2013. The Final Call…

Co-authors: Tara E. Swenson, Theresa C. Carnegie.

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OIG approves gift cards to encourage clinical visits to health center *

USA - January 9 2013
In Advisory Opinion 12-21, the OIG concluded that a Federally qualified health center's offer of grocery store gift cards to capitated managed care…

Co-authors: Theresa C. Carnegie.

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Medicare star ratings–what plan sponsors need to know *

USA - November 30 2012
On Oct. 12, the Centers for Medicare & Medicaid Services published its 2013 Medicare Health Plan Quality and Performance Ratings, also called ‘‘Star Ratings’’ or ‘‘Plan Ratings.’’

Co-authors: Theresa C. Carnegie.

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