HealthExec February 25, 2024
CMS recently proposed new rules detailing how it wants to cover individuals who qualify for both Medicare and Medicaid. The authors of a new analysis cheer on the suggested changes, stating the updated governance will—if finalized and adopted for target year 2025—not only integrate coverage for underserved populations but also clamp down on the “games” that Medicare Advantage plans have been known to “play.”
Private suppliers of these plans sometimes enroll individuals only in Medicare Advantage products, the authors explain. In so doing, plan administrators miss chances to integrate Medicaid programs on behalf of many underserved patients, they point out.
The authors are Michael Monson and Sarah Barth of the Michigan-based nonprofit Altarum, which conducts research related to economically vulnerable...
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