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Health Insurance & Benefits
Plan types, HSAs/FSAs, open enrollment, and navigating coverage denials/appeals.
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OIG urges crackdown on equipment suppliers in Medicare Advantage
7+ hour, 23+ min ago (462+ words) The agency says the CMS and MA organizations aren’t doing enough to screen durable medical equipment providers, especially out-of-network companies that aren’t enrolled in Medicare. Fraud related to DMEPOS – prosthetics, robotics, orthotics and supplies – “has been a long-standing issue in…...
New documents reveal problems with Medicare's prior-authorization pilot
8+ hour, 34+ min ago (131+ words) STAT is a media company focused on finding and telling compelling stories about health, medicine, and scientific discovery. We produce daily news, investigative articles, and narrative projects in addition to multimedia features, podcasts, and opinion pieces. We tell our stories…...
Advantage Plans Can Cap Your In-Network Bills at $9,250. A PPO's Combined Cap Can Reach $13,900, and Covered Out-of-Network Care Counts Toward the Bigger One
10+ hour, 10+ min ago (648+ words) She chose her Medicare Advantage PPO because it promised a clear out-of-pocket ceiling, and she planned her knee surgery around that number. What she did not know was that one out-of-network provider on her surgical team would activate an entirely…...
Should you get original Medicare or an Advantage plan? Here’s what to know
12+ hour, 40+ min ago (1561+ words) Open enrollment for Medicare starts soon, so it’s time to start thinking about what’s next for your healthcare. The public insurance is for people 65 and older, although some younger people who have certain disabilities or conditions may also be eligible....
Community Connection - When your doctor falls out of your Medicare Advantage plan network
1+ day, 5+ hour ago (374+ words) Mike Hitcho, CEO of Hitcho Insurance Agency, explains the costs and ramifications of losing access to your doctor in a Medicare Advantage plan. Mike Hitcho discusses the proactive approach Hitcho Insurance Agency takes when a medical provider gets dropped from…...
Belfast Health Trust building abandoned 20 years ago branded a ‘danger’ as kids use TikTok to arrange hangouts inside
2+ day, 16+ hour ago (530+ words) A building that could potentially provide social housing or assisted living has been described as a “merry-go-round for antisocial behaviour” after lying vacant for more than two decades. Minnowburn House, off the Old Milltown Road in Belfast, served a number…...
29 Health Systems Dropping Medicare Advantage Plans
1+ week, 5+ hour ago (872+ words) The number of terminated contracts this year is down from 40 in 2025 and 32 in 2024, Becker’s Hospital Review reported on Sept. 4. Naples Comprehensive Health, one of the top 50 U.S. hospitals, will go out of network with Centene’s Wellcare and Health Care Service…...
How Medical Denial Management Actually Works (And Why Most Practices Get It Wrong)
3+ day, 2+ hour ago (31+ words) Claim denials cost healthcare practices more than most providers realize — not just in lost revenue, but in staff …...
Guest Commentary | ‘Prior authorization’ remains a pain point for physicians, patients
4+ day, 20+ hour ago (382+ words) Physicians devote the early part of their careers to education and training. They spend years honing and refining their clinical skills through medical school, internships, residencies and fellowships. Finally, they are ready and eager to step out on their own…...
157 Lab Providers Lost Medicare Billing Privileges—Here’s Why Checking Your Medicare Statement Matters
5+ day, 4+ hour ago (192+ words) According to CMS, those systems look for abnormal combinations involving testing, results, billing, documentation, and relationships that could indicate fraud, waste, or abuse. The technology can help flag high-risk claims for additional review and potentially allow claims to be held,…...