Responding to criticisms lodged against an otherwise popular program among seniors, Senators Bill Cassidy, M.D. (R-LA) and Jeff Merkley (D-OR) introduced a bill to improve the way Medicare Advantage ...

Inpatient encounters for Medicare patients 65 years and older are associated with higher coding intensity compared with commercially insured, Medicaid, or self-pay hospitalizations for those same ...

An analysis of differential coding patterns between Medicare Advantage (MA) and Traditional Medicare (TM) plans estimated how much coding differs between insurers and how much extra revenue insurers ...

Differential coding by Medicare Advantage plans appeared to have pushed their risk scores higher than traditional Medicare's scores. Those greater risk scores led to $33 billion in extra revenue for ...

In 2016 Medicare introduced advance care planning Current Procedural Terminology (CPT) codes to reimburse clinicians for time spent providing the service. Despite recent increases, use of these codes ...

New legislation introduced in the Senate by Bill Cassidy, R-La., and Jeff Merkley, D-Or., seeks to curb overpayments to Medicare Advantage plans by imposing changes to MA risk adjustment. The No ...

Payments to Medicare Advantage (MA) plans are adjusted by a risk-score model that is calibrated on diagnostic and demographic data from traditional Medicare beneficiaries and then applied to MA ...

Enrollment among beneficiaries in Medicare Parts A and B in Medicare Advantage plans was 46% this year. (Getty/designer491) () Most Medicare beneficiaries in Parts A and B are expected to be enrolled ...