Medicare Advantage Enrollment Reaches 31 Million Though Is Slowing
In an analysis by the Chartis Group, enrollment in Medicare Advantage 2023 plans is up 5.5%. Last year's signups grew 9% over the previous year. Other news relates to inpatient claim denials, Medicare drug pricing negotiations, and more.
Modern Healthcare:
Medicare Advantage Enrollment Growth Slowed For 2023
Medicare Advantage growth slowed for the 2023 plan year, according to a report the Chartis Group published Tuesday. Enrollment increased 5.5% for this year, down from a record 9% the prior year, driven by California and a handful of other states where the number of people signed up for private Medicare plans actually fell, said Nick Herro, a principal at the Chartis Group and co-author of the study. (Tepper, 2/21)
Healthcare Finance News:
Medicare Advantage Plans Denying More Inpatient Claims
Healthcare systems have found themselves in precarious financial standing due to a dramatic increase in the number of inpatient claims being denied by health insurers based on the lack of medical necessity, according to data collected by accounting and technology firm Crowe. These level-of-care reimbursement disputes are especially rising in frequency among Medicare Advantage plans. (Lagasse, 2/21)
North Carolina Health News:
Medicare Advantage Faces New Challenges To Costs, Practices
The popular Medicare Advantage program, known for attractive perks — yet questioned for some policies — is facing a recent series of critiques over its practices and cost to the U.S. budget. It’s part of what might be called a battle for Medicare’s heart and soul being fought by powerful interests in North Carolina, where hundreds of thousands have enrolled for the plan, and beyond. (Goldsmith, 2/22)
On Medicare drug costs —
Bloomberg Law:
Drug Price Negotiation Deadlines Expose Medicare To Litigation
The Medicare agency risks legal challenges from the pharmaceutical industry as it scrambles to meet rapidly approaching deadlines in President Joe Biden’s landmark drug pricing law, attorneys say. The timeline Congress set in the Inflation Reduction Act (Public Law 117-169) to begin negotiating certain drug prices are “tremendously tight” for the Centers for Medicare & Medicaid Services, said Jonathan Blum, the agency’s principal deputy administrator and chief operating officer. (Castronuovo, 2/22)
Fierce Healthcare:
Senators Urge CMS To Rethink Coverage For Alzheimer's Drugs
A group of senators is urging the Biden administration to rethink its restrictive coverage determination for emerging Alzheimer's disease treatments. The letter to Department of Health and Human Services Secretary Xavier Becerra and Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure is signed by 20 senators comprising 18 Republicans and two Democrats. (Minemyer, 2/21)
Meanwhile, Sen. Bernie Sanders is skeptical about the future of Medicare for All —
The Hill:
Sanders: Medicare-For-All ‘Ain’t Going To Happen’ In Divided Congress
Sen. Bernie Sanders (I-Vt.) said “Medicare for All,” a system that would establish government-run health care for all U.S. citizens, “ain’t going to happen” during the next two years amid a divided Congress. (Gans, 2/21)
On Medicaid news from Missouri and Tennessee —
St. Louis Public Radio:
Missouri Senate Gives Initial Approval To Maternal Health Bill
The Missouri Senate has given initial approval to expanding how long someone would have access to Medicaid coverage after giving birth. However, the expansion will only occur after around 5,000 people are removed from the state’s Medicaid program. Senators gave first-round approval to legislation on Tuesday that expands coverage for one full year after giving birth. It must go through one more vote before moving on to the House. (Kellogg, 2/21)
KHN:
In Tennessee, A Medicaid Mix-Up Might Land You On A ‘Most Wanted’ List
Life was upended for LaShonia Ingram over the past year, and a shadow still follows her around. Search her name online, and the first result includes the words “fraud” and “most wanted.” “It was horrible. I couldn’t get a job,” said the 42-year-old mother from Memphis, Tennessee. “All doors were being closed in my face.” (Farmer, 2/22)
