Prior authorizations are the way MA managed care plans pre-approve some procedures before they’ll pay for them.

The difficulty that stakeholders face in comparing contracts with different structures could be solved by a standardized ...

“I'm not exactly sure, because I’m not in there. I mean, it is difficult to integrate them, because Medicare is under fee for ...

Declining enrollment, fewer plan offerings, and persistently higher premiums are raising concerns about the stability and ...

Shifting from reducing MA capitation by an across-the-board coding intensity adjustment factor to Medicare Advantage ...

Medicare Advantage patients treated in value-based care models saw better outcomes than those treated in fee-for-service ...

Opens in a new tab or window Share on LinkedIn. Opens in a new tab or window Physicians would get a 3% Medicare fee-for-service pay increase -- with primary care doctors getting a little more and ...

The Medicare policy change added something that's common in private insurance and Medicare Advantage, but rare in traditional fee-for-service Medicare: requiring doctors to get prior authorization ...

Medicare's mandatory TEAM demonstration for surgical care requires coordination between hospitals and post-acute care ...

OBFA and its partners signed a letter to the leadership in both the U.S. House of Representatives and U.S. Senate requesting that Medicare Physician Fee Schedule ... new site-of-service for ...

sometimes called Original Medicare, and through HMOs, PPOs and private fee for service plans for beneficiaries who have Medicare Advantage Part C. What is covered under Part D? Private companies ...