Medicare Beneficiaries

Latest Headlines

Latest Headlines

N.Y. long-term care plan pays $47M for enrolling ineligible beneficiaries

A managed care organization that specializes in long term care in New York City has agreed to pay $47 million for enrolling ineligible beneficiaries in the plan, according to the New York Attorney General's Office.  

Medicare to pay for pricey cancer drug

Medicare will soon start paying for a new and pricey cancer medication, Blincyto, which costs about $178,000 for a standard course of treatment.

Medicare Part B premiums may increase 52 percent

Nearly a third of Medicare beneficiaries may face a 52 percent increase in Part B premiums unless the Department of Health and Human Services steps in.

CMS issues final rule on appeal rights for applicable plans

The Centers for Medicare & Medicaid Services  issued a final rule last week regarding the formal appeals process for applicable plans in situations where the agency seeks Medicare Secondary Payer recovery from an applicable plan. The rule is effective April 28.

Aetna fined $1 million for Medicare Part D in-network mishap

The Centers for Medicare & Medicaid Services has fined Aetna $1 million for the insurer's recent mishap of wrongly identifying 6,887 pharmacies as being in its network.

Regional culture impacts inappropriate imaging for prostate, breast cancer

In determining the level of use of healthcare imaging resources, research published this week in  JAMA Oncology  found that regional factors are of high importance. Being able to better understand those patterns, the study's authors said, could help make better use of healthcare programs.

New bipartisan bill takes aim at Medicare fraud

Two U.S. Representatives from the Ways and Means Health Subcommittee introduced a new bill focused on preventing Medicare fraud "by making a number of common sense reforms." The finalized bill is an updated version of the draft bill first released in August that targets various avenues of fraud from prescription drugs to durable medical equipment. 

Updated: Aetna wrongly identifies Part D in-network pharmacies

Because health insurance company Aetna wrongly identified some 5,000 pharmacies as being in-network, more than 400,000 Medicare beneficiaries have until the end of February to either find other pharmacies or switch plans.

Insurers, states strike hepatitis C deals with pharmaceutical companies

Both insurers and state Medicaid agencies are working to secure discounts on pricey hepatitis C drugs.

Feds charge patients for complicity in ambulance fraud

Federal authorities in Philadelphia brought charges Thursday against four Medicare beneficiaries accused of accepting kickbacks for taking unnecessary ambulance trips and convincing others to do likewise, the  Philadelphia Business Journal  reported.