CMS Delays Medicare Advantage Rule Requiring Reminders Of Unused Perks
The agency says it needs time "to address logistical concerns and reevaluate current requirements" regarding a notification policy about unused benefits. Plus, UnitedHealth's intentions for Medicare Advantage plans.
Modern Healthcare:
CMS Drops Medicare Advantage Unused Benefits Notification Policy
Medicare Advantage carriers will not be required to remind members about unused supplemental benefits, the Centers for Medicare and Medicaid Services notified insurers Monday. CMS will not enforce the mandate “while it reconsiders the regulatory requirements,” the agency wrote in a memo to health insurance companies. The policy was scheduled to take effect next year. (Tong, 9/9)
Modern Healthcare:
UnitedHealth, HCSC Cut Medicare Advantage Commissions
UnitedHealthcare is backing away from many Medicare Advantage plans as it seeks to restore profitability to the business. The UnitedHealth Group subsidiary will cease paying commissions on new sales of 18% of its products for 2026, the company notified third-party marketers Tuesday. UnitedHealthcare will pay only partial commissions for another 2% of its Medicare Advantage plans. The insurer will continue to compensate brokers for renewals. (Tepper, 9/9)
Modern Healthcare:
UnitedHealth Expects Most Medicare Advantage Members In Top Plans
The vast majority of UnitedHealthcare Medicare Advantage members will be enrolled in policies with high quality scores next year, parent company UnitedHealth Group announced Tuesday. UnitedHealthcare anticipates that 78% of its Medicare Advantage enrollees in 2026 will have plans in contracts that earned at least four out of five stars under the Star Ratings quality measurement program. That compares with 71% this year. (Tepper, 9/9)
In other health industry news —
Modern Healthcare:
Pacs Group's CFO Derick Apt Resigns
Pacs Group Chief Financial Officer Derick Apt resigned from the troubled nursing home company last week after he allegedly accepted improper gifts from related parties. The company said in a Monday Securities and Exchange Commission filing that Apt resigned Sept. 2 after an audit committee alleged he violated the company’s code of conduct by accepting high-value items from individuals associated with entities that do business with Pacs Group. Efforts to reach Apt were unsuccessful. (Eastabrook, 9/9)
Modern Healthcare:
How Hospital Presumptive Eligibility Can Help With Medicaid Cuts
Hospitals are ramping up strategies to prevent Medicaid patients from losing coverage as they try to get ahead of federal policy changes. A growing number of providers are pursuing hospital designations that allow them to streamline the Medicaid enrollment process, known as presumptive eligibility. Others are enlisting vendors to collect and organize patient data and partnering with community organizations to bridge coverage gaps. (Kacik, 9/9)
Newsweek:
How Health Systems Are Turning Living Rooms Into Hospital Rooms
Erica Olenski's North Texas home is a constant churn of activity, as is typical for a family with two young boys. Scattered about are baseball bats, book bags, bicycles. But that's where the ordinary ends. Olenski's son, August, was diagnosed with an aggressive form of brain cancer in May of 2019, at 5 months old. For the next six years, their home served as a personal intensive care unit. (Kayser, 9/10)
