Increases are expected to become effective in calendar 2024.
The Centers for Medicare & Medicaid Services (CMS) have released the Announcement of Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the Rate Announcement).
The capitation rates provide the base amount paid to MA plans prior to risk score adjustments.
The Biden Administration finalized a proposal to raise Medicare Advantage payments by 3.32 percent in 2024, slightly above the 1 percent raise that it proposed.
The Inflation Reduction Act 2023 (IRA) made several improvements to the standard Part D drug benefit defined in the Social Security Act. Part D benefit-related IRA updates that will be in place for CY 2024 include the following:
The IRA passage in August of this year is expected to affect the healthcare of millions of Americans. Provisions will change how certain drug prices get determined, limit out-of-pocket costs for older Americans, and could help ensure continued coverage for Medicaid beneficiaries when the COVID-19 Public Health Emergency (PHE) ends May 11.
Programming note: Listen to Tim Powell’s live news reports every Tuesday morning on Talk Ten Tuesdays with Chuck Buck and Dr. Erica Remer.
The Centers for Medicare & Medicaid Services (CMS) operates a surveillance platform called the Fraud Prevention System (FPS) that analyzes Medicare claims across the full
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As AI reshapes healthcare compliance, the risk of biased outputs and opaque decision-making grows. This webcast, led by Frank Cohen, delivers a practical Four-Pillar Governance Framework—Transparency, Accountability, Fairness, and Explainability—to help you govern AI-driven claim auditing with confidence. Learn how to identify and mitigate bias, implement robust human oversight, and document defensible AI review processes that regulators and auditors will accept. Discover concrete remedies, from rotation protocols to uncertainty scoring, and actionable steps to evaluate vendors before contracts are signed. In a regulatory landscape that moves faster than ever, gain the tools to stay compliant, defend your processes, and reduce liability while maintaining operational effectiveness.
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