Tag: Medicare

Medicare has a new initiative that will cover up to eight over-the-counter COVID-19 tests each calendar month, at no cost to you. 

California Attorney General Rob Bonta announced on February 24th, the arrests of 14 individuals who were charged in San Bernardino County Superior Court in connection with two hospice companies accused of stealing more than $4.2 million from the federal Medicare and state Medi-Cal programs. Based in San Bernardino County, New Hope Hospice, Inc. and Sterling Hospice Care, Inc. enrolled patients who were not terminally ill into hospice care, many of whom told investigators that they were enrolled without their knowledge or understanding of what hospice was. All of the arrested defendants face multiple felony counts including conspiracy to commit insurance fraud, insurance fraud, grand theft, and fraudulent insurance claims, with some defendants also facing charges related to identity theft, money laundering, and tax evasion. Two defendants remain at large.

As part of the Biden-Harris Administration’s ongoing efforts to expand Americans’ access to free testing, people in either Original Medicare or Medicare Advantage will be able to get over-the-counter COVID-19 tests at no cost starting in early spring. Under the new initiative, Medicare beneficiaries will be able to access up to eight over-the-counter COVID-19 tests per month for free. Tests will be available through eligible pharmacies and other participating entities. This policy will apply to COVID-19 over-the-counter tests approved or authorized by the U.S. Food and Drug Administration (FDA).

As part of the Biden-Harris Administration’s ongoing efforts to expand Americans’ access to free testing, people in either Original Medicare or Medicare Advantage will be able to get over-the-counter COVID-19 tests at no cost starting in early spring. Under the new initiative, Medicare beneficiaries will be able to access up to eight over-the-counter COVID-19 tests per month for free.

This week, Congressman Raul Ruiz, M.D. (CA-36) called on the Department of Health and Human Services to guarantee at-home COVID-19 test kits to Medicare beneficiaries at no cost.

The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers. It also establishes an independent dispute resolution process for payment disputes between plans and providers, and provides new dispute resolution opportunities for uninsured and self-pay individuals when they receive a medical bill that is substantially greater than the good faith estimate they get from the provider.

The Centers for Medicare & Medicaid Services (CMS) has released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP)—all key connectors to care for more than 135 million Americans.[1]

Last year Ellin and her husband, both new to Medicare, signed up for a Medicare Advantage plan from Essence Healthcare, a managed care firm based in a St. Louis suburb. She contacted me wanting to share her experiences in choosing a Medicare Advantage plan to cover what the Medicare program does not pay, and agreed to track how the plan paid for services throughout the year — especially the heavily advertised extra benefits such as vision and dental touted in TV ads during this season’s open enrollment period.

A new Health Navigation Pilot Program is underway at Inland Empire Health Plan (IEHP), connecting patients in Barstow to primary care physicians, needed social services, and more. 

Improper payments represent payments that do not meet program requirements. The vast majority of improper payments occur in regards to people who may be eligible for care, but for whom there was an unintentional payment error or a reviewer cannot determine if a payment was proper due to insufficient payment documentation from a state or a provider.