In January, new federal rules will pose restrictions on how Medicare Advantage plans use algorithm tools that match patients with similar diagnoses and characteristics to make some coverage decisions.
The U.S. Department of Health and Human Services has received complaints from around the country about unsolicited tests being billed to Medicare. Could this be a trial run for further fraud?
The proposed changes would be particularly important for patients undergoing treatments that weaken the immune system, giving any dental infections the opportunity to spread.
The Centers for Medicare & Medicaid Services (CMS) has expanded how it defines the "primarily health-related" benefits that insurers are allowed to include in their Medicare Advantage policies.