CMS reports Medicare fee-for-service improper payments at $28.8 billion in fiscal 2025, with a 6.55% improper payment rate, down from 2024.

Service (FFS) estimated improper payment rate was 6.55%, or $28.83 billion, compared to the FY 2024 reported rate of 7.66%, or $31.70 billion, according to a new fact sheet from the Centers ...

Medicare Advantage payments are $76 billion above what spending would have been in fee-for-service Medicare in 2026, ...

By a News Reporter-Staff News Editor at Insurance Daily News-- Data detailed on Managed Care have been presented. The news correspondents obtained a quote from the research from Augusta University,“ ...

The authors of the study and the editorial note that a primary limitation on these findings is the concentration of Medicare ...

According to telehealth.org, policy changes have also helped telehealth become a permanent option for Medicare patients. The Consolidated Appropriations Acts of 2021 and 2023 removed limits on where ...

Original Medicare primarily operates on a fee-for-service (FFS) system, billing for each service provided. Some Medicare Advantage (Part C) plans also use this payment model via private FFS plans.

Difference in spending attributed to "coding intensity" and "favorable selection" ...

Private Fee-for-Service (PFFS) plans are one of four main types of Medicare Advantage policies that private insurance companies administer. The plans have specific rules relating to costs paid to ...

A deep dive into the work of one Medicaid contractor is offering stark new insights into how often Medicare Advantage plans deny nursing home coverage, how they time their decisions and why it matters ...