Angel Abrego’s Post

Good to see this RFI from Centers for Medicare & Medicaid Services. More sunshine about what tax payers and people enrolled in Medicare Advantage actually get can and should lead to reporting and quality improvements. https://lnkd.in/eAwikVw5 #medicareadvantage

The finalized 2025 MA rates are more than just a component of the wider healthcare regulatory framework; they are strategic imperatives that require a diligent, collaborative, and innovative response from health insurance professionals. By understanding the nuanced implications and strategically addressing the changes, healthcare organizations stand to harness these rates as a platform for sustained growth, improved care quality, and operational excellence.

On January 1 took effect a Centers for Medicare & Medicaid Services’ (CMS) new rule to streamline the #priorauthorization process. #managedcare #utilizationmanagement #medicare #medicine #pharmacy

The recent announcement of the 2025 Medicare Advantage (MA) rates by the Centers for Medicare & Medicaid Services (CMS) is a crucial roadmap that outlines a year ahead under a complex funding mechanism. This article caters is for those looking to understand the deep-seated implications of these rates and to strategize proficiently come 2025.

PLANNING AHEAD: How Medicare services at home differ from at-home Medicaid http://ow.ly/5uwi30sCv3H

The Centers for Medicare & Medicaid Services' final Access and Managed Care rules reflect the biggest regulatory changes to Medicaid and CHIP in nearly a decade. Here's how states should respond.

The Medicare Part C+D rule changes proposed by Centers for Medicare & Medicaid Services rewards brokers for the guidance they provide seniors—not for steering consumers to the plan with the highest payout. That’s why ACHP and our members support it. Let’s get it finalized.    More of our comments on the proposed rule changes here:  https://lnkd.in/eefnCCmS

Prior authorization is such a huge issue for the healthcare system - Please read this article to understand what you need to do to avoid coverage denials.

Medicare Advantage plans and hospital systems are jumping ship in many markets and states. Why? More pressure, more scrutiny, and less margins. I have heard the D-SNPs are gaining steam. D-SNP are the Dual-eligible Special Needs Plans for people eligible for both Medicare and Medicaid. Keep an eye on this space with these two articles: 1. From the Center for Economic and Policy Research https://lnkd.in/e4HC3Buk 2. From the Kaiser Family Foundation https://lnkd.in/eyF_8fqs.

We applaud the decision by the Centers for Medicare and Medicaid Services (CMS) to temporarily retain CY2024 agent compensation rates for CY2025. While we were not of the opinion that the original 2025 compensation guidelines applied to eHealth, we’re gratified by CMS’s decision to keep the 2024 guidelines in place, which we strongly believe will serve the best interests of Medicare beneficiaries this Annual Enrollment Period (AEP). This year’s AEP is expected to be especially challenging and disruptive for seniors. It is gratifying to know that CMS’s decision to retain 2024 compensation guidelines helps ensure that all Medicare beneficiaries can have the benefit of working with a licensed agent to help guide them through their coverage decisions. #CMS #fransoistman #medicare