OIG Finds Inappropriate Service Denials by MAOs

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An Office of Inspector General (OIG) report determined that Medicare Advantage Organizations (MAOs) sometimes delayed or denied Medicare Advantage beneficiaries’ access to services, even though the requests met Medicare coverage rules. MAOs also denied payments to providers for some services that met both Medicare coverage rules and MAO billing rules. In the report, Some Medicare Advantage Organization Denials […]

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Webinar: Unleashing the Capabilities of MAOs to Deliver Health Innovation for Older Adults in Underserved Settings

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Thursday, October 7 2:30PM – 4:00PM ET REGISTER As part of a broader partnership, CMMI, the Office of the Assistant Secretary for Health (OASH) and the Administration for Community Living (ACL) are jointly sponsoring a webinar titled, Unleashing the Capabilities of MAOs to Deliver Health Innovation for Older Adults in Underserved Settings on October 7 from 2:30-4:00 […]

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CMS Releases List of MA Plans Offering Hospice under VBID Model in CY2022

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On September 29, 2021, the Centers for Medicare & Medicaid Services (CMS) released the list of Medicare Advantage (MA) plans that will participate in the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model during Calendar Year (CY) 2022, including those that will participate in the MA VBID Hospice Benefit Component, which began operation in January […]

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CMS Directs MAC Outreach to Hospices in MA VBID Demonstration Model Areas

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Beginning on January 1, 2021, through the VBID Model, participating Medicare Advantage Organizations (MAOs) can voluntarily participate in the Hospice Benefit Component of the Model, according to a November 13 transmittal (10458/CR 12045) from the Centers for Medicare & Medicaid Services (CMS).  During CY2021, nine plans will test coverage of Hospice as part of their […]

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