UnitedHealth sued over alleged use of AI to deny elderly patients care
Families of former beneficiaries claim UnitedHealth's AI system "aggressively" rejected claims for medically necessary expenses.
Source: yahoo.com
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New Medicare Advantage Regulations Add Provider and Beneficiary Protections Against Plan Utilization Management Policies | King & Spalding
On April 5, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a Final Rule (CMS-4201-F) regarding the Medicare Advantage (MA) and Part D programs. The Final Rule includes...
Source: jdsupra.com
Medicare Program; Contract Year 2023 Policy And Technical Changes To The Medicare Advantage And Medicare Prescription Drug Benefit Programs; Policy And Regulatory Revisions In Response To The COVID-19 Public Health Emergency; Additional Policy And Regulatory Revisions In Response To The COVID-19 Public Health Emergency – InsuranceNewsNet
Agency: " Centers for Medicare& Medicaid Services, Department of Health and Human Services." This final rule finalizes certain 2021 and 2022 Star Ratings provisions that were included in two interim final rules with comment period that CMS issued on April 6, 2020, and September 2, 2020; other policies from those interim final rules will be addressed in other...
Source: insurancenewsnet.com
Abbott Receives Expanded Medicare Reimbursement for First-Of-Its-Kind MitraClip™ Device
Share this article Share this article ABBOTT PARK, Ill., Jan. 20, 2021 /PRNewswire/ -- Abbott (NYSE: ABT) today announced that the U.S. Centers for Medicare & Medicaid Services (CMS) revised its National Coverage Determination (NCD) to expand coverage for transcatheter edge-to-edge repair (TEER), also referred to as transcatheter mitral valve repair (TMVr), to include patients with secondary (or functional) mitral regurgitation (MR) resulting from heart failure. The decision significantly increases the number of people eligible for insurance coverage for mitral valve repair with MitraClip, ...
Source: prnewswire.com
Medicare Expands Coverage for MitraClip in Heart Failure Patients
Medicare Expands Coverage for MitraClip in Heart Failure Patients New national reimbursement significantly expand access to transcatheter mitral valve repair procedures for secondary mitral regurgitation January 20, 2021 — The U.S. Centers for Medicare and Medicaid Services (CMS) revised its National Coverage Determination (NCD) to expand coverage for the Abbott MitraClip to include patients with secondary (or functional) mitral regurgitation (MR) resulting from heart failure. The procedure is known as transcatheter edge-to-edge repair (TEER), but is also referred to as transcatheter mitral...
Source: dicardiology.com