Medicare Advantage Changes 2024

[somarco]

CMS will implement new risk adjustment payment rates, prior authorization requirements and network standards for Medicare Advantage plans in 2024.

Beginning in 2024, plans cannot impose any prior authorization requirements for any ongoing treatments during the first 90 days a member is enrolled in a plan.

Medicare Advantage plans will be required to establish a utilization management committee to review policies annually and ensure policies are in line with traditional Medicare's requirements.
https://www.beckerspayer.com/policy-updates/5-medicare-advantage-changes-coming-in-2024.html

Will the utilization committee fact check the AI decisions?

 

[Midlevel]

CMS will implement new risk adjustment payment rates, prior authorization requirements and network standards for Medicare Advantage plans in 2024.

Beginning in 2024, plans cannot impose any prior authorization requirements for any ongoing treatments during the first 90 days a member is enrolled in a plan.

Medicare Advantage plans will be required to establish a utilization management committee to review policies annually and ensure policies are in line with traditional Medicare's requirements.
https://www.beckerspayer.com/policy-updates/5-medicare-advantage-changes-coming-in-2024.html

Will the utilization committee fact check the AI decisions?

Damn, just when you think the MAPD’s couldn’t get any better for clients they just did. Awesome news!

 

[Yagents]

Mapd plans were awesome already. Why does it need to be fixed? Why only 90 days?

 

[axeman462]

CMS will implement new risk adjustment payment rates, prior authorization requirements and network standards for Medicare Advantage plans in 2024.

Beginning in 2024, plans cannot impose any prior authorization requirements for any ongoing treatments during the first 90 days a member is enrolled in a plan.

Medicare Advantage plans will be required to establish a utilization management committee to review policies annually and ensure policies are in line with traditional Medicare's requirements.
https://www.beckerspayer.com/policy-updates/5-medicare-advantage-changes-coming-in-2024.html

Will the utilization committee fact check the AI decisions?

I guess that means you will have to stay up even later at night scouring the internet for hit pieces on MAPD next year

 

[Yagents]

The best agents actually stay on top of industry news daily. You just accept whatever you are fed by your upline.

 

[axeman462]

The best agents actually stay on top of industry news daily. You just accept whatever you are fed by your upline.

@Todd King never feeds me any info, ever. It actually what I like about him being my upline.
And I would consider myself one of the best brokers in the industry. I offer my clients a wide array of products, not a one-size-fits-all solution to ever problem.

The problem with the Medsupp only agents, is that when your only tool in the toolbox is a hammer, every problem looks like a nail.

But when you have several tools to choose from, you can always do right by the client. Every time.

Just do right by people. It's not that hard.

Why make it harder than it has to be?

 

[policywunk]

@Todd King never feeds me any info, ever. It actually what I like about him being my upline.
And I would consider myself one of the best brokers in the industry. I offer my clients a wide array of products, not a one-size-fits-all solution to ever problem.

The problem with the Medsupp only agents, is that when your only tool in the toolbox is a hammer, every problem looks like a nail.

But when you have several tools to choose from, you can always do right by the client. Every time.

Just do right by people. It's not that hard.

Why make it harder than it has to be?

or is the problem that to med supp only agents every prospect looks like a tool waiting to be hammered with scare tactics ? Discuss amongst yourselves.

 

[Midlevel]

Mapd plans were awesome already. Why does it need to be fixed? Why only 90 days?

You are correct but now even better!!!!

 

[Yagents]

See, I experience the dark side of HMO's daily with half my book being ACA. Do you have any experience with clients under 65 that have been fighting with HMO carriers for a decade? I do.

So, when they T65, I am done with hearing their sad stories. I have a ONE time opportunity (and a choice) to fix that problem with OM med supp.

If they can't afford it, I understand and refer them to a trusted mapd agent. I get to choose what I sell, just like you.

 

[thomasm]

Maybe Nikki Haley was right. The solution to saving Medicare from BK is selling more MA plans.