The three organizations have publicly announced their intent to integrate operations to better serve the industry and the American people. The respective boards of all three organizations voted to move forward with merging together pending an overall vote by the membership.
New KFF analyses highlight trends in enrollment, benefits and cost-sharing, and bonus payments for Medicare Advantage Plans
Federal spending on bonus payments to insurance companies that offer Medicare Advantage plans will reach at least $12.8 billion in 2023, according to a new KFF analysis. That is a nearly 30% increase from 2022, and more than quadruple the spending in 2015.
These data come from one of three analyses released today by KFF that examine various facets of the Medicare Advantage program, which provides health insurance coverage to nearly 31 million Americans. KFF examined trends in enrollment, premiums, out-of-pocket limits, cost sharing, supplemental benefits, prior authorization, star ratings and bonus payments.
The pharmaceutical company Merck on Tuesday sued the federal government over legislation that empowers Medicare for the first time to negotiate prices directly with drugmakers.
Merck’s lawsuit, filed in federal court in Washington, is the drug industry’s most significant move so far to fight back against a substantial change to health policy, which will go into effect starting in 2026. Democrats pushed through the Medicare-negotiation program last summer as a provision of the Inflation Reduction Act, framing it as a way of lowering drug prices.
https://www.nytimes.com/2023/06/06/business/merck-medicare-drug-prices.html
Based on data compiled information from the NAIC and other sources, CSG Actuarial is reporting total earned premiums in the Medicare Supplement market in 2022 totaled $36.1 billion, a 1.4% increase over 2021.
Report Highlights:
The total Medicare Supplement lives covered in 2022 decreased slightly to 14.3 million. CSG Actuarial believes this decrease was due to increased competitive pressures from Medicare Advantage plans and a decrease in the overall Medicare growth rate due to Covid deaths in 2020, 2021, and 2022.
Top 12 Carriers in terms of 2022 Medicare Supplement Premiums:
The 2022 overall Medicare Supplement market loss ratio of 80.4% returned to normal historical levels due to a rebound in utilization of non-Covid medical care the past two years.
Fifteen of the top 20 Medicare Supplement carriers reported a decrease in in-force Medicare Supplement lives in 2022.
*Data Source: National Association of Insurance Commissioners, by permission. The NAIC does not endorse any analysis or conclusions based upon the use of its data.
News Release – Ohio Department of Insurance
April 3, 2023
Free Statewide “Welcome to Medicare” Educational Events Available to Ohioans New to Medicare
COLUMBUS – The Ohio Senior Health Insurance Information Program (OSHIIP), the state’s official Medicare educational and counseling program, is holding free in-person and virtual “Welcome to Medicare” events across Ohio from April through June for Ohioans new to Medicare, Ohio Department of Insurance director Judith L. French announced. OSHIIP is a department program.
“Medicare is complicated and there are different health insurance approaches along with health care and budgetary considerations for Ohioans new to Medicare to evaluate,” French said. “OSHIIP’s Medicare representatives narrow the scope while still thoroughly educating Ohioans about Medicare so they can make informed health insurance decisions best suited for their needs.”
During the events, OSHIIP representatives provide an overview of Medicare, Part A and B benefits, Part D prescription drug coverage, Medicare supplemental insurance plans, Medicare Advantage plans, eligibility, enrollment, financial assistance, and important deadlines. One-on-one follow-up counseling sessions can be scheduled.
Last year, OSHIIP through its different engagement services counseled and educated nearly 600,000 people and saved Ohioans on Medicare $46 million by helping them identify suitable coverage options and financial assistance.
To access the in-person and virtual Welcome to Medicare events schedules, visit insurance.ohio.gov. OSHIIP representatives are also available at 800-686-1578 and oshiipmail@insurance.ohio.gov to answer Medicare questions.
For Medicare information and tips, answers to frequently asked questions, and insight into how to avoid Medicare scams visit insurance.ohio.gov and medicare.gov.
Biden Administration Releases Timeline for Implementation of Inflation Reduction Act Medicare Provisions
The administration released a timeline for implementation of certain Inflation Reduction Act (IRA) provisions, including provisions related to Medicare drug price negotiations.
As we have mentioned previously, the IRA grants the secretary of HHS the ability to negotiate the prices of certain drugs for the Medicare program with new prices beginning in 2026. Ten Part D drugs will be negotiated in 2026, with an additional 15 Part D drugs in 2027, 15 Part B or D drugs in 2028, 20 Part B or D drugs in 2029, and 20 more drugs each year beyond that. The bill dictates that the secretary can only negotiate prices on costly single-source drugs, those among the highest-spend products in Part B or Part D that do not have competing small-molecule generics or biosimilars that are both FDA-approved and marketed. The legislation also exempts “small biotech drugs” from negotiation until 2028….
PLUS! DOWNLOAD A CMS PDF OF THE IRA TIMELINE FOR A QUICK REFERENCE
KFF: The Average Medicare Beneficiary Has a Choice of 43 Medicare Advantage Plans and 24 Part D Stand-Alone Plans for Coverage in 2023Meredith Freed Follow @meredith_freed on Twitter , Jeannie Fuglesten Biniek Follow @jeanniebin on Twitter , Anthony Damico , and Tricia Neuman Follow @tricia_neuman on Twitter For 2023, the typical beneficiary has a choice of 43 Medicare Advantage plans as an alternative to traditional Medicare, a new KFF analysis finds. That’s an increase of 5 plans on average from 2022, adding even more choices to the Medicare Advantage marketplace, which is poised to become the dominant way Medicare beneficiaries get their health coverage and care. In addition, the typical beneficiary has a choice of 24 Medicare Part D stand-alone prescription drug plans for 2023, a second KFF analysis finds, one more than in 2022. These findings are featured in two briefs released by KFF today that provide an overview of the Medicare Advantage and Medicare Part D marketplace for 2023, including the latest data and key trends. Medicare’s open enrollment period began Oct. 15 and runs through Dec. 7. Medicare Advantage More than 28 million Medicare beneficiaries – 48 percent of all eligible beneficiaries – are enrolled in Medicare Advantage plans, which are mostly HMOs and PPOs offered by private insurers. Enrollment is projected to cross the 50 percent threshold as soon as next year.
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