Podcasts about Medicare Advantage

In this timely roundtable, Lisa and Hemma sit down with Mary Inman and Liz Soltan, two powerhouse advocates in the whistleblower legal space, to unpack the DOJ's newly revised Corporate Whistleblower Awards (CWA) Pilot Program and its implications for the compliance community.  We also explore what makes whistleblowing work, how to support internal and external reporters, and why this moment may mark a turning point for global whistleblower engagement. Highlights: Mary and Liz break down the newly added DOJ priority areas How the CWA Pilot Program could evolve into a DOJ equivalent of the SEC whistleblower program Why organizational justice and psychological safety must be embedded into internal reporting systems. How tips must result in asset forfeiture to trigger awards Why we need a speak-up culture, not just a hotline Resources  DOJ's May 2025 Criminal Division White-Collar Enforcement Plan Revised DOJ Corporate Whistleblower Awards Pilot Program: DOJ Announcement Speech by Matthew R. Galeotti at the SIFMA AML and Financial Crimes Conference Link to speech Whistleblowing Study by Stephen Stubbens and Kyle Welch Whistleblower Partners LLP: Mary Inman, Liz Soltan Biographies   Mary Inman Partner, Whistleblower Partners LLP Mary Inman is a seasoned attorney with over 30 years of experience representing whistleblowers under various U.S. programs, including the False Claims Act, SEC, CFTC, IRS, FinCEN, and NHTSA/DOT. After spending three years in London, she now focuses on international whistleblowers exposing misconduct with ties to the U.S.. She assists clients in bringing claims to foreign regulators such as the Ontario Securities Commission and the Canada Revenue Agency. Mary is renowned for her expertise in healthcare, tech, and financial services fraud. She has represented high-profile whistleblowers like Frances Haugen (Facebook) and Tyler Shultz (Theranos), and co-authored The Tech Workers' Handbook, a guide for tech industry whistleblowers. Her advocacy extends to testifying before global governmental bodies, including the European Commission and UK Parliament, championing the effectiveness of U.S. whistleblower programs. Mary holds a J.D. from the University of Pennsylvania Law School and has clerked for judges in both the U.S. District Court and the U.S. Court of Appeals. Outside of her legal work, she enjoys participating in her husband's YouTube channel and spending time in northern Maine. Liz Soltan Associate, Whistleblower Partners LLP Liz Soltan is an associate at Whistleblower Partners LLP, focusing on cases involving financial fraud, anti-money laundering, and sanctions evasion. Her notable work includes representing a foreign whistleblower in a FinCEN sanctions violation case concerning illegal sales to Russia. Liz also contributed to the landmark Medicare Advantage risk adjustment fraud case, United States ex rel. Poehling v. UnitedHealth Group, Inc. Before joining Whistleblower Partners, Liz served as a Skadden Fellow at Community Legal Services of Philadelphia, where she was part of a team that secured $712 million in emergency food stamp benefits for 650,000 households during the COVID-19 pandemic. She earned her J.D. cum laude from Harvard Law School, where she led the Wage and Hour Practice Group at the Harvard Legal Aid Bureau and successfully argued a workers' rights case before Massachusetts' highest court. Liz completed her undergraduate studies at Cornell University, graduating summa cum laude with a major in History and a minor in Spanish. Residing in Brooklyn, Liz maintains strong ties to her Philadelphia roots. She enjoys participating in a fiction-only book club, exploring historical sites, and spending time with her husband, son, and their two cats, Alex Trebek and Vanna White.

https://www.kff.org/medicare/issue-brief/key-facts-about-medigap-enrollment-and-premiums-for-medicare-beneficiaries/ If you would like to work with Christian on your Medicare Health Plan, we currently work with people in 45 states. Those are the states we currently are licensed in. Christian and Christian Brindle Insurance Services represents many of the top insurance companies in the Medicare industry. Contact us for more information:➡️Our Site: https://https://www.christianbrindleinsuranceservices.com/ ✅Call (801)-255-5340.

During the next edition of Monitor Mondays, famed whistleblower attorney Mary Inman, partner at Whistleblower Law, will provide an update on a whistleblower case that some consider “beyond bad.”You'll learn why a Texas rheumatologist who was sentenced to 10 years in prison and three years of supervised release was ordered to forfeit more than $28 million, plus 13 real-estate properties, a jet, and a Maserati GranTurismo sports car.Inman, long considered one of the nation's foremost whistleblower attorneys, will be the program's special guest during the next live edition of the venerable Internet broadcast, coming up at 10 a.m. EST on Monday, June 2, 2025.The long-running broadcast will also include these instantly recognizable features:Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.Field Report: Drew Updike will continue his reporting on efforts by the Trump Administration to intervene in healthcare issues – namely the Centers for Medicare & Medicaid Services (CMS) Form 64 related to migrants and Medicaid.

In this episode, Mary N. Mannix, President and CEO of Augusta Health, shares insights on navigating Medicaid and Medicare Advantage challenges, the importance of innovation in healthcare, and Augusta Health's investment in workforce development through its new graduate medical education program. She also discusses the organization's commitment to community health and the power of leading with optimism.

JCO Editorial Fellow Dr. Lauren Shih and JCO Associate Editor Dr. Stephanie Wheeler discuss the ASCO 25 Simultaneous Publication paper "Use of Low-Value Cancer Treatments in Medicare Advantage Versus Traditional Medicare." Transcript The guest on this podcast episode has no disclosures to declare. Dr. Lauren Shih: Hello, and welcome to our 2025 ASCO annual meeting series where we cover some of the top JCO papers published simultaneously with their abstract presentations at this year's meeting. I'm your host, Dr. Lauren Shih, JCO editorial fellow, and I'm joined by JCO Associate Editor Dr. Stephanie Wheeler to discuss the Journal of Clinical Oncology article and abstract presentation "Use of Low-Value Cancer Treatments in Medicare Advantage Versus Traditional Medicare." Let's start with the relevance of the article. Dr. Wheeler, can you explain this to our listeners? Dr. Stephanie Wheeler: Thank you so much. Let's get right into it. So this article is really about understanding different types of Medicare plans and what we should expect to see in terms of their use of low-value treatments for cancer patients. So, as Medicare really is focused on trying to limit the use of low-value cancer treatments, we really need to better understand the drivers of variability. So we know that many cancer patients have multiple treatment options available to them. We also know that the vast majority of older adults beyond age 65 are insured by Medicare, and about half of them are on Medicare Advantage plans, which are serviced by private insurance. And private insurance companies in this case are receiving capitated payments for Medicare beneficiaries to manage their service utilization and reduce costs. So, with respect to Medicare Advantage versus the traditional fee-for-service Medicare, it's not really been known to what extent low-value treatments are differentially used by these types of plans for cancer patients. And so that was really the focus of this article. What the authors found is that across six different types of treatments, in general, the folks who were enrolled in Medicare Advantage plans had reduced use of low-value treatment. So that's a good sign for Medicare beneficiaries. And although the relative difference in that use was somewhat low, this translates to a significant number of Medicare enrollees across the country not receiving these low-value treatments. And of course, this translates to considerable savings at the society level. Dr. Lauren Shih: Are there any additional key results that we should review? Dr. Stephanie Wheeler: Yeah. So I'll tell you just a little bit more about the methods and also their findings. So they looked at six different low-value treatments, and this was in, again, 100% of national Medicare enrollees from 2015 through 2021. So the six low-value treatments that they examined were the use of G-CSFs among patients receiving low-risk chemotherapy and denosumab for those who had castration-sensitive prostate cancer. Then they also looked at four high-cost treatments, including using nab-paclitaxel instead of paclitaxel for patients with breast or lung cancer; second, adding bevacizumab to carboplatin plus paclitaxel for ovarian cancer; third, using brand-name drugs instead of generics when generics were available; and fourth, using biologics instead of biosimilars when biosimilars were available. And these are all, by the way, non-recommended treatments according to a variety of guidelines, including NCCN and ASCO's Choosing Wisely guidelines. So they used the Medicare claims data to examine use of these regimens. They also analyzed results by type of Medicare Advantage plan, whether people were enrolled in a health maintenance organization plan, or an HMO, or a preferred provider organization plan, or a PPO. They also looked at the largest Medicare Advantage insurers—including Aetna, Blue Cross Blue Shield, Cigna, Humana, and UnitedHealth—and limited their analyses to those that had complete encounter data. And what they found across the board is that the enrollees in Medicare Advantage plans generally had lower use of these low-value treatments. And the largest differences between Medicare Advantage and traditional Medicare plans were in the outcomes, including G-CSF use and using denosumab for castration-resistant prostate cancer, and then the combination of bevacizumab, carboplatin, and paclitaxel versus carboplatin and paclitaxel. And all of these had a change in use ranging from about 19% change to 24% change in use. This is significant as a field as we look at ways in which different plan organization can influence use of treatments, particularly given the excess cost of cancer care. This is something we really want to pay attention to. So I'd encourage folks to look more closely at the results by treatment type as well as the results by plan type to see a little bit more about what was going on across different plan types. Dr. Lauren Shih: Great. And are there any outstanding questions that need to be answered? Dr. Stephanie Wheeler: Yes, there always are, of course. I think the study has several strengths that are worth noting. First, they have 100% of Medicare enrollees, so there's national coverage there, which is, you know, quite outstanding. They also use an appropriate choice of analysis to help deal with some of the selection. So they use inverse probability of treatment weights, and they control for practice and county indicators to try to get some realistic adjustment for the selection that happens in terms of how patients are enrolled in different Medicare Advantage versus traditional fee-for-Medicare plans. These statistical approaches are a good idea, but they are limited by the observed variables that we can use for these kinds of adjustments. And so any unobserved—confounding or any unobserved factors that would influence selection in these plans aren't going to be captured well. So preferences, for example, that patients may have about different types of plans when they're insuring themselves and their families may not be captured. Second, the data that are used are only encounter data from those plans with complete records. That may mean that smaller Medicare Advantage insurers or those that don't have as comprehensive records are not included. So this may not be reflective of their practice patterns. And then third, of course, this only looked at six different low-value cancer treatments. It remains to be seen whether this kind of finding extends to other types of low-value cancer treatments, and that's an opportunity for future study. Finally, I would say that we don't exactly know why these patterns exist. It could be that Medicare Advantage plans have different approaches to prior authorization. They could have more in-house quality control and management to really understand, among their population for whom they're receiving Medicare Advantage payments, to really look at care quality and assess Choosing Wisely guidelines. We don't know exactly how that's playing out. And so we need additional data to really figure out what's working here and what are opportunities for future policy and payment innovations that can further reduce low-value care. Dr. Lauren Shih: Great. Thank you so much, Dr. Wheeler, for speaking to us about the JCO article, "Use of Low-Value Cancer Treatments in Medicare Advantage Versus Traditional Medicare." We really appreciate your insights. Dr. Stephanie Wheeler: Thanks for having me. Dr. Lauren Shih: Join us again for the latest simultaneous publications from the ASCO 2025 Annual Meeting. Please take a moment to rate, review, and subscribe to all ASCO podcast shows at asco.org/podcasts. Until then, enjoy the rest of ASCO 2025. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

In the "Medicare Advantage Minute" we go through news article reporting that the majority of MA members are confused. It had some other negatives to report about Medicare Advantage as well In "Your Medicare Benefits 2024 (or maybe 2025)" we learn exactly how Medicare covers in-home hospice care. Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2025; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers. Official website: https://www.MedicareForTheLazyMan.com.

Lee Camp digs into the recent Venezuelan elections, 10 horrible things hidden inside Trump's "beautiful" bill, and moreTo learn more about Chapter Medicare Advice, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

We have a special guest on today's episode whose voice will be familiar to regular listeners. Last year at this time, Dr. Raven Baxter occupied the Raise the Line host chair for a special ten-part series we produced in collaboration with the Cohen Center for Recovery from Complex Chronic Illness (CoRe) at Mount Sinai in New York City, where she serves as the Director of Science Communication. The series explored the latest understandings of post-acute infection syndromes -- such as Chronic Lyme and Long COVID -- with an array of experts from the Center and other researchers and providers. In this episode, we check-in with Dr. Baxter to get an update on the work of the Cohen Center, especially with regard to its mission to educate providers. “We're building programs so that clinicians can earn credit for learning about chronic illnesses that are infection associated, and we've also developed a 200-page provider manual. I really think that we will be able to shift the narrative that currently exists,” Dr. Baxter tells host Michael Carrese. That narrative includes lingering skepticism among providers of some infection-associated illnesses, which Dr. Baxter witnessed herself as a Long COVID patient, an experience that has added meaningful perspective to her work. Dr. Baxter is also working on her own time to advance knowledge and combat misinformation through a robust social media presence as “The Science Maven” and helps other scientists and clinicians to do the same. "If we're not there to fill in that void, other people will fill it for us and the narrative may not be consistent with the truth or facts." This is a great opportunity to learn about the art and science of communications that can reach clinicians and patients alike.Mentioned in this episode:Cohen Center for Recovery from Complex Chronic IllnessThe Science Maven If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

The former Israeli Prime Minister Ehud Olmert has accused Israel of war crimes. Plus the US and Germany have decided to remove all range restrictions for Ukraine.To learn more about Chapter Medicare Advice, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

Are hospitals locking out Medicare Advantage enrollees? Find out the likely real reason behind the shutout and why we should be worried if MA can no longer compete with traditional fee-for-service Medicare. Join AnneMarie Schieber, managing editor of Health Care News, and Devon Herrick of the Goodman Institute Health Blog as they discuss the latest headlines in health care from a free-market perspective. Also on their radar: the mad rush by states to pass assisted medical suicide bills. Is the U.S. becoming Canada? Is assisted suicide becoming a means to ration ever-escalating health care costs?Additionally, former President Joe Biden's aggressive prostate cancer is receiving increasing attention as Congress probes who knew what—and when—about Biden's cognitive impairment. How in the world could a president not be screened regularly for a condition he previously had? Finally, will it be the carrot or the stick when it comes to creating rules based on the MAHA Commission report? In The Tank broadcasts LIVE every Thursday at 12pm CT on on The Heartland Institute YouTube channel. Tune in to have your comments addressed live by the In The Tank Crew. Be sure to subscribe and never miss an episode. See you there!Climate Change Roundtable is LIVE every Friday at 12pm CT on The Heartland Institute YouTube channel. Have a topic you want addressed? Join the live show and leave a comment for our panelists and we'll cover it during the live show!

Trump's lies are not words; they have deadly and costly effects producing calamitous consequences. AOC scolds Republicans for supporting the for-profit Medicare Advantage waste fraud and abuse.Subscribe to our Newsletter:https://politicsdoneright.com/newsletterPurchase our Books: As I See It: https://amzn.to/3XpvW5o How To Make AmericaUtopia: https://amzn.to/3VKVFnG It's Worth It: https://amzn.to/3VFByXP Lose Weight And BeFit Now: https://amzn.to/3xiQK3K Tribulations of anAfro-Latino Caribbean man: https://amzn.to/4c09rbE

Patients with Medicare Advantage insurance coverage: rural hospitals are asking themselves whether they can afford to keep accepting them! This is the subject of our "Medicare Advantage Minute" today. In "Your Medicare Benefits 2025" we learn how Medicare would cover home infusion therapy services. Then we spot check some rate increase statistics in order to determine whether inflationary trends are still exerting upward pressure on insurance premiums. They are. Medicare is not allowed to provide and pay for drugs whose only function is weight loss. Some of the newly distributed GLP-1 drugs provide weight loss effects as well as beneficial treatment of heart disease and type 2 diabetes. This causes a high demand for these expensive meds. Finally, we learn what some pinko organization thinks are the best states and worst states for overall health care access. Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2025; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers. Official website: https://www.MedicareForTheLazyMan.com.

Join us at the Seven Figure Medicare Agent Summit: https://sevenfiguremedicareagentsummit.com/On this episode of the Seven Figures or Bust podcast, we address the growing trend of non-commissionable Medicare plans and what it means for agents. With major carriers like Aetna, Cigna, and Elevance Health shifting certain Medicare Advantage and Part D plans to non-commissionable status for 2025, agents face new challenges in maintaining their income streams . We delve into strategies for navigating these changes, including diversifying your product offerings and ensuring compliance with CMS guidelines when discussing non-commissionable plansGets Leads from Lead heroes here: https://leadheroes.com/Learn more about getting your own VA with Hire Heroes here: https://app.hireheroes.com/signup?fpr=christian43Join our free private Facebook group for insurance agents: https://www.facebook.com/groups/551409828919739/Welcome to the Christian Brindle channel brought to you by Christian Brindle & Christian Brindle Insurance Services. This channel is here for the sole purpose of bringing training, tips, success stories, and personal development from Christian Brindle. Christian is a published author, hosts the ever popular Everything Medicare Podcast, and made six figures in the Medicare business by the time he was 25 years old.

* AOC scolds Republicans for supporting the for-profit Medicare Advantage waste, fraud, and abuse: Alexandria Ocasio-Cortez explains the Medicare Advantage waste, fraud, and abuse, and challenges Republicans to support an amendment to take back the stolen money to enhance Americans' healthcare. [More]* When Trump Lies, Democracy Dies: Trump's lies are no lo… To hear more, visit egberto.substack.com

AOC scolds Republicans for supporting the for-profit Medicare Advantage waste, fraud, and abuse. CNN's Jake Tapper allows the Speaker to spin. This is a five-alarm fire.Subscribe to our Newsletter:https://politicsdoneright.com/newsletterPurchase our Books: As I See It: https://amzn.to/3XpvW5o How To Make AmericaUtopia: https://amzn.to/3VKVFnG It's Worth It: https://amzn.to/3VFByXP Lose Weight And BeFit Now: https://amzn.to/3xiQK3K Tribulations of anAfro-Latino Caribbean man: https://amzn.to/4c09rbE

Alexandria Ocasio-Cortez explains the Medicare Advantage waste, fraud, and abuse, and challenges Republicans to support an amendment to take back the stolen money to enhance Americans' healthcare.Subscribe to our Newsletter:https://politicsdoneright.com/newsletterPurchase our Books: As I See It: https://amzn.to/3XpvW5o How To Make AmericaUtopia: https://amzn.to/3VKVFnG It's Worth It: https://amzn.to/3VFByXP Lose Weight And BeFit Now: https://amzn.to/3xiQK3K Tribulations of anAfro-Latino Caribbean man: https://amzn.to/4c09rbE

In our MA Minute we scan the article:      Medicare vs. Medicare Advantage; Ill health often leads to a plan switch! Bottom line: if one gets sick, one begins to see how MA plans can cause misery! In today's "Your Medicare Benefits" we learn how and when Medicare will help with Home Health Services. Client Robert from Virginia is unhappy with the level of Medical inflation that has caused his HDG rates to increase 19%. His home state has just enacted a birthday rule whereby Robert can change companies without having to provide evidence of good health. Birthday rules like this are spreading across the land. Insurance companies say they drive up their costs, leading to premium increases. On the other hand, they can allow overburdened people covered by expensive supplements to have an escape hatch.  Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2025; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers. Official website: https://www.MedicareForTheLazyMan.com.

Thank you Manuel Olmo, Penelope Lane, Thomas Paramo, Jo Ann Haymond, Sandy Keithline, and many others for tuning into my live video! Join me for my next live video in the app.* AOC scolds Republicans for supporting the for-profit Medicare Advantage waste fraud and abuse: Alexandria Ocasio-Cortez explains the Medicare Advantage waste, fraud, and abuse, and challenges Republicans to support an amendment to take back the s… To hear more, visit egberto.substack.com

Lee Camp and Eleanor Goldfield cover Trump's new massive giveaway to the rich, cuts for the poor. Plus, Israel sh---ing at diplomats, and much more!To get FREE help navigating Medicare and Medicare Advantage, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option. *Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

May 23, 2025 Scott, Mark, and Ray answer listener questions on coding for remote uroflowmetry, defining high-complexity MDM, and dealing with low Medicare Advantage reimbursements. They discuss CPT code options, provide examples of immediate-risk diagnoses, and offer strategies for contract negotiations. PRS Coding and Reimbursement HubAccess the HubJelmyto Coding and Reimbursement PageUpper Track Urothelial Cancer (UTUC) Coding and Reimbursement PageFree Kidney Stone Coding CalculatorDownload NowPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.https://www.prsnetwork.com/joinuptp Click Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

S&P Futures are trading slightly higher this morning after Wednesday's sell-off, which was triggered by a spike in Treasury yields amid concerns about a significant expansion in U.S. fiscal debt. The House is expected to pass Trump's tax and spending bill this morning; the vote is currently underway. Robert F. Kennedy Jr.'s “Make America Health Again” report is expected to be released today. Health insurer stocks are under pressure this morning following the Centers for Medicare & Medicaid Services' announcement of expanded audits of Medicare Advantage plans. AT&T has agreed to acquire substantially all of Lumen Technologies' mass markets fiber business for $5.75 billion in cash.  Reports on Jobless Claims and the flash PMI report for May will be released today. On the earning front SNOW, URBN, ZM & AAP are higher after their releases. After the bell today earnings reports from INTU, WDAY, ADSK, CPRT, ROST and DECK are set to report.

This podcast is brought to you by Outcomes Rocket, your exclusive healthcare marketing agency. Learn how to accelerate your growth by going to outcomesrocket.com What if the key to transforming healthcare isn't just technology, but bringing compassionate, personalized care back into the home? In this episode, Dr. Jessica Son, Chief Medical Officer of Clover Care Services at Clover Health, shared her journey from primary care physician to healthcare executive, driven by a desire to fix systemic gaps she observed while doing house-call medicine. At Clover Health, a next-generation Medicare Advantage company, she leads value-based care initiatives that combine technology with human-centered delivery. Their AI-powered Clover Assistant equips physicians with real-time insights to improve outcomes and reduce care gaps, while an in-home clinical team ensures patients receive personalized and coordinated support. Dr. Son emphasized the urgency of proactive, compassionate care amid a strained healthcare system and a growing elderly population. She welcomes partnerships with organizations and providers who share Clover's mission to improve lives through holistic, home-based care. Tune in for a powerful conversation on how Clover Health is blending technology, human connection, and home-based support to improve outcomes for those who need it most! Resources: Connect with and follow Dr. Jessica Son on LinkedIn. Follow Clover Health on LinkedIn and explore their website.

In this episode of the Becker's Healthcare Podcast, Erika Spicer Mason speaks with Brian Workinger and Lauree Handlon of The Craneware Group about how AI and data-driven insights are helping providers navigate increasingly complex payer contracting and reimbursement environments. The conversation covers predictive modeling, payer transparency, and preparing for shifts in Medicare Advantage participation, all within the broader context of value-based care. Tune in to hear how hospitals can leverage advanced analytics to drive smarter financial strategies and improve long-term sustainability.This episode is sponsored by Craneware.

Lee Camp digs into Trump's admission that 300,000 Gazans have been killed, DOGE may be coming to an end, a social media star is mocked for speaking to the police, Biden has cancer, and Trump is working to crush the ICC. All that and more!To learn more about Chapter Medicare Advice, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

In this debut episode of Quality Talks With Peggy O'Kane, Founder and President of NCQA, Peggy is joined by Dr. Sachin Jain, CEO of SCAN Group and SCAN Health Plan, to explore a provocative question: Why isn't health care better at getting better?Measuring—Not Missing—What Matters: Anxieties about access and affordability plague everyday people. But quality measurement's focus is elsewhere. Is health care chasing the wrong metrics and missing the big picture? The Complacency Crisis: Sachin says the core issue is a reluctance to embrace real reform, noting the industry's tendency to want improvement without being willing to change fundamental practices. He calls for a bolder approach. Rethinking Medicare & Medicare Advantage: Sachin challenges rosy view of traditional Medicare, and describes how a legal battle over a flawed Medicare Advantage star rating raised questions about how measuring quality affects care. Simplifying for Impact: Sachin proposes focusing on three or four areas, emphasizing patient experience, ease of access and basic care for common conditions. He urges cost transparency, simpler administrative processes and renewed competition.Key Quote:“ If we all just took care of our own part of the ecosystem, we'd get 20, 30% better. But instead, the most industry talking points are about, ‘Hey, we don't get paid enough for what we do.' Everyone who's making money claims that they're losing money on X, Y, or Z lines of business. Everyone complains about regulatory capture, so there's just a bit of having normalized the abnormal. And I think that that's the thing we have to undo if we're going to actually make the kinds of forward progress that we're hoping to make as an industry.”-Sachin Jain, MDTime Stamps:(01:44) Inspired by Our Mentors in Health Care(04:27) How Does Health Care Get Better?(7:28) The Trap of Toxic Positivity (11:34) Misplaced Nostalgia for Traditional Medicare(18:05) The Stars Program Controversy(22:13) Simplifying Health Care MeasurementLinks:Connect with Sachin Learn More About SCANConnect with PeggyLearn More About NCQA

Welcome to a strange new world.Recent tariffs announced by the Trump Administration are likely to impact drug manufacturing, since many drug components are produced outside the U.S., in nations such as in India, giving rise to state laws. Many states limit overseas involvement relative to the Health Insurance Portability and Accountability Act (HIPAA). Florida, for example, prohibits the offshoring of certain patient data, requiring such storage to be within the U.S.Responding to this emerging crisis, the producers of RACmonitor and Monitor Mondays have invited Lexi Morrison, director of operations at MedPharma, to be the program's special guest during the next live edition of the venerable Internet broadcast, coming up at 10 a.m. EST on Monday, May 19.The long-running broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Adam Brenman, senior government affairs analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.

ChatGPT Interviews Jae Oh: United HeathGroup InvestigationUnitedHealthcare Under Federal Investigation: What Medicare Advantage Members Need to Know NowBrief DescriptionUnitedHealth Group—the largest Medicare Advantage provider—is under criminal investigation by the DOJ, potentially impacting over 35 million members. Jae Oh answers the 10 urgent questions every Medicare Advantage enrollee should be asking. No fluff. Just facts.In This Video00:00:00 DOJ vs UnitedHealth: What's Really Going On?00:01:45 Will Your Medicare Advantage Plan Be Affected?00:03:15 How Could Fines Impact Future Benefits?00:05:15 Could This Reshape Medicare Advantage Regulation?00:07:00 Can You Switch Plans Now If You're Worried?00:09:30 Who Should Still Care Even If Not With UHC?00:11:30 What Should Brokers & Agents Be Doing?00:13:15 Why Risk Coding Opened the Door to Abuse00:15:30 Is This Just the Start of More Investigations?00:17:00 What Every Medicare-Eligible Person Must Do NowSocial Media Post

The $84 billion question haunting American healthcare takes center stage as Nathan Kaufman returns to unpack the bombshell criminal investigation into UnitedHealthcare's alleged Medicare fraud. Drawing from his 48 years of healthcare expertise, Kaufman reveals the troubling mechanics behind how the nation's largest insurer potentially manipulated the Medicare Advantage system through aggressive "upcoding" – artificially inflating patient illness scores to extract higher government payments.This eye-opening conversation exposes the stark reality that UnitedHealthcare somehow generated a staggering 95% of all Medicare Advantage profits in 2024, raising serious questions about their operational practices compared to competitors. We dive deep into the company's concerning denial patterns, where approximately one in ten Medicare Advantage claims gets rejected, yet when patients fight back, 70-80% of appeals succeed – suggesting many initial denials lack merit.Beyond the investigation itself, we explore the fundamental conflict at the heart of our healthcare system: the misaligned incentives that reward denying care rather than providing it. As Kaufman aptly describes healthcare as "the largest segment of the largest economy in the history of the world," we confront the uncomfortable truth that 24 cents of every federal dollar now flows into a system that too often prioritizes corporate profits over patient wellbeing. Whether you're concerned about healthcare costs, insurance practices, or the future of Medicare and Medicaid, this conversation offers crucial insights into how the complexity and opacity of our healthcare system benefits powerful interests while leaving patients vulnerable. Subscribe now to join our growing community of listeners seeking fiercely nonpartisan analysis of today's most pressing issues.Support the showEngage the conversation on Substack at The Common Bridge!

Story of the Week (DR):UnitedHealth Group CEO Andrew Witty steps down for 'personal reasons' MM DRUnitedHealth Under Investigation: UnitedHealth Group is facing a criminal probe by the U.S. Department of Justice for potential Medicare fraud related to its Medicare Advantage program. The company is also dealing with a civil fraud investigation and has suspended its 2025 financial forecast amid rising medical costs. CEO Andrew Witty resigned unexpectedly this week.Steve will receive a golden hello again consisting of a one-time $60M option award. While the company claims there will be no additional annual equity awards during the first three years of Steve's employment, there are no performance hurdles tied to this award meaning Steve could make a boatload of cash even if the stock market goes up independent of his work as CEO.A Kohl's board member resigned because she was 'continually disappointed' by governance and a lack of transparency MM DRKohl's Director and Compensation Committee Chair Christine Day resigned from the board on May 5, 2025.Kohl's initially claimed: “Ms. Day's decision [to resign] was not due to any disagreements with the Company on any matter relating to the Company's operations, policies or practices.”Day later sent an email (included in SEC filing) saying:I want to stress my concern that this is an inappropriate way to handle this. All shareholders deserve the same access to the same information. [ . . .] and for us to not respond to ISS is not good governance. In the 8K filing, for my departure, it would not be accurate to say I have no disagreements with the board. Unfortunately I have been continually disappointed with the level of governance process. The 8k needs to reflect this.”In another email she called out Board Chair Michael Bender: “There is no delegation to committees or chairs, Michael “handles” everything, maybe speaks to one person or 2, then “tells” everyone what the decision is. Some people know more than others leading to board members feeling alienated, out of the loop, and worse—developing a culture where real discussions rarely occur.”In a meeting held yesterday (may 14), only 5% of Kohls shareholders said NO to Board Chair Michael Bender while 45% said NO on Pay while average director support was 92% YESJohn Tyson joins Tyson Foods Inc. board, 9 months after criminal charges led him to step down as CFO MM DRDespite being part of the controlling family, The Tyson children will be paid $315,000 annually like all other non-employee directors.FedEx board member David Steiner to lead US Postal ServiceLD since 2009; CEO Waste Management; $15M in sharesGoodliest of the Week (MM/DR):DR: Boulder's landmark lawsuit against Suncor, Exxon can proceed, Colorado Supreme Court rulesMM: NLPC Urges Exxon Mobil Shareholders To Vote Against Election Of CEO Darren Woods For Board On Exxon Mobil's 2025 Proxy Ballot DR MMThey are running a vote no campaign on Darren Woods… for being too woke! After suing his own shareholder who wanted him to be woke!Assholiest of the Week (MM):NasdaqNasdaq Supports Texas Senate Bill 29, Strengthening Corporate Governance and Business Growth in the State DREd Knight of Nasdaq says: “Senate Bill 29 is a milestone for corporate governance in Texas. By embracing smart, innovation-focused regulation like SB 29, Texas is showing the world what it means to lead on economic growth and modern, clear governance principles,” said Ed Knight, Executive Vice Chairman of Nasdaq. “We commend Senator Bryan Hughes, Representative Morgan Meyer, and Governor Greg Abbott for advancing legislation that strengthens Texas' position as a global center for capital formation.”The major features include a Musk “board independence” rule that allows an evidentiary hearing by a court to say a committee overseeing a transaction is “independent”, then they can exclude any lawsuits or challenges to the committee findings/approval - say, on something like a massive pay package - without the ability of a shareholder to get recourseThey also can refuse books and records if they THINK you might sue them, and they only allow derivative lawsuits for groups with 3% or more of the sharesEd Knight biography: A Texas native, Knight received his Bachelor of Arts, with honors, in Latin American Studies from the University of Texas at Austin and his Juris Doctorate from the University of Texas School of Law.Stewardship teamsHarley-Davidson Leaders Survive Proxy FightThe company didn't reveal the preliminary vote total during its shareholder meeting. About 48% of shares voted withheld support from Zeitz, while about 40% withheld support from directors Thomas Linebarger and Sara Levinson, two people familiar with the tally said.Harley's bylaws require directors to resign if more than 50% of shares voted withhold support.Seriously investors? Seriously? Levinson has been a director since Clinton's FIRST TERM - AND SHE HAS A CHECKMARK FOR INDEPENDENT. 30 years isn't too much for you investors? 30? For an ex NFL and MTV executive at a company that makes motorcycles? If you're anti-woke, isn't this an easy vote out?? Not even for her woman-ness, but for the fact that she has literally nothing to do with making motorcycles? She started a women-focused dot com media company called “Club Mom”!If Blackrock and Vanguard voted to support Harley directors, they truly do not care - and ISS's fuckwit half-assed non-assessment is what's driving investors to do-nothingness. And I know ISS is listening, we've been told they don't like our criticism - tough shit, your assessments are feckless bullshit nothingburger with no real backing, and pension funds are starting to notice you give them a whole lot of puffery for 200k a yearIn other news… BlackRock wins 67% support for pay as CEO Fink assures on global economyEach of its 18 director nominees were easily elected with average support over 98%.Press ReleasesLumen Technologies Appoints Michelle J. Goldberg and Steve McMillan to Board, Strengthening Company's AI and Digital StrategyBecause no one cares, no one reads the bios to determine if, at least on paper, the headline matches the humans - “strengthening company's AI and digital strategy”Michelle J. Goldberg brings over 20 years of experience in early-stage technology, finance, and board governance. She served as a Partner at venture capital firm Ignition Partners and currently sits on the boards of both Bakkt Holdings and Ally Financial, previously having held board roles at Legg Mason, Taubman Centers, and Plum Creek Timber. Her expertise and guidance in early-stage technology startups has helped scale businesses through critical phases of innovation and expansion. Michelle holds a BA from Columbia University and an MA from Harvard University.Steve McMillan is a seasoned executive in global enterprise technology strategy, data analytics and big data. Since 2020, he has served as President and CEO of Teradata Corporation. His previous leadership roles at F5, Oracle, and IBM specialized in security, cloud management, and managed services—making him a key voice in modernizing technology platforms for customer success. Steve earned a First-Class Honours degree in Management and Computer Science from Aston University in Birmingham, England.So… not AI or digital strategy experts?Headliniest of the WeekDR: Elon Musk says everyone will want their 'personal robot' — but warns of 'Terminator'-style risksDR: Elon Musk's AI says it was ‘instructed by my creators at xAI' to accept the narrative of ‘white genocide' in South AfricaMM: Women contribute less to climate-heating emissions than men, study finds - this explains the anti woke movement, the atmosphere is super woke MM: Elon Musk's pro-Trump PAC failed to pay swing state petition signers, new suit allegesWho Won the Week?DR: Olivia Tyson, for being the nepobaby nobody notices (when standing next to John R. Tyson)MM: The A in AI, since Elon has proven that you really don't need the “intelligence” part.PredictionsDR: After Disney CEO Bob Iger hears me on The Responsible Investor Podcast with Gina Gambetta he sends a cease and desist letter forcing me off all podcasts until 1001 years of the next popeMM: Exxon sues the NLPC for its exempt solicitation, and no one knows who to root for.

Medicare Advantage (MA) is one of the most popular insurance programs for the Medicare-eligible population, however it faces significant headwinds from both payer and provider organizations. Alan Lassiter, Principal, ECG Management Consultants, speaks with Christine Worthen, Member, Epstein Becker & Green PC, and Joe Mangrum, Partner, ECG Management Consultants, about the current state of MA, the complex issues confronting both payers and providers, and strategies for successfully navigating these uncertain times. They discuss issues related to provider-sponsored plans, structuring value-based arrangements with MA plans, how MA plans can maintain margin, CMS' recent final rule, sustainable MA plan reimbursement, network design and supplemental benefits, and the value drivers of data. From AHLA's Payers, Plans, and Managed Care Practice Group.AHLA's Health Law Daily Podcast Is Here! AHLA's popular Health Law Daily email newsletter is now a daily podcast, exclusively for AHLA Premium members. Get all your health law news from the major media outlets on this new podcast! To subscribe and add this private podcast feed to your podcast app, go to americanhealthlaw.org/dailypodcast.

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Dr. Damanjeet Chaubey, Vice President of Clinical Affairs at Clover Health. Dr. Chaubey shares how Clover is leveraging AI-powered technology, proactive care models, and home-based strategies to improve outcomes, reduce costs, and redefine Medicare Advantage.

In this episode, Scott Becker discusses the mounting challenges facing UnitedHealthcare, including a DOJ investigation into Medicare Advantage fraud, the abrupt resignation of CEO Andrew Whitty, and a steep stock decline shaking investor confidence.

On this episode of “Raise the Line” we welcome Dr. Sheldon Fields, a trailblazer in the nursing field and the president of the National Black Nurses Association. In a candid conversation, Dr. Fields shares his inspiring journey from the bedside to becoming a prominent figure in nursing, HIV/AIDS prevention and academia and also shares the challenges he faced as a Black man in a predominantly white and female field. "I fell in love with a profession that has not always loved me back," he tells host Kelsey Lafayette. Dr. Fields brings over thirty years of experience as an educator, researcher, clinician, administrator, consultant, health policy specialist, and entrepreneur to his current role at NBNA, and as the inaugural associate dean for equity and inclusion at the College of Nursing at Penn State University, where he also serves as a research professor. Listeners will find Dr. Fields' insights on navigating a career in healthcare particularly valuable, as he stresses the importance of resilience, continuing education, and mentorship. It's a compelling listen for anyone interested in the intersection of health, policy, and social justice.Mentioned in this episode:National Black Nurses Association If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

Host Dr. Jay Anders discusses all things value based care with guest Lynn Carroll, COO of HSBlox. Together they discuss the evolving dynamics of Medicare Advantage plans, proposed changes under the new White House Administration, the dual role of artificial intelligence to clean up claims and streamline workflows, and how the value-based care model continues to rise in importance. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

The pressure mounts for UnitedHealth (UNH) as shares plummet following news of a DOJ probe into its Medicare Advantage program. Diane King Hall joins Caroline Woods at the NYSE set to dive into the report as UNH shares reach 4-year lows. Later, she looks overseas at Chinese tech stock Alibaba (BABA) after it reported a revenue miss in its 4Q earnings. Meanwhile, Cisco (CSCO) shares are higher after the legacy tech company raised its guidance on stronger A.I. demand.======== Schwab Network ========Empowering every investor and trader, every market day.Subscribe to the Market Minute newsletter - https://schwabnetwork.com/subscribeDownload the iOS app - https://apps.apple.com/us/app/schwab-network/id1460719185Download the Amazon Fire Tv App - https://www.amazon.com/TD-Ameritrade-Network/dp/B07KRD76C7Watch on Sling - https://watch.sling.com/1/asset/191928615bd8d47686f94682aefaa007/watchWatch on Vizio - https://www.vizio.com/en/watchfreeplus-exploreWatch on DistroTV - https://www.distro.tv/live/schwab-network/Follow us on X – https://twitter.com/schwabnetworkFollow us on Facebook – https://www.facebook.com/schwabnetworkFollow us on LinkedIn - https://www.linkedin.com/company/schwab-network/About Schwab Network - https://schwabnetwork.com/about

In this episode, Scott Becker discusses the mounting challenges facing UnitedHealthcare, including a DOJ investigation into Medicare Advantage fraud, the abrupt resignation of CEO Andrew Whitty, and a steep stock decline shaking investor confidence.

Today's Headlines: President Trump kicked off his Middle East trip in Saudi Arabia, meeting with Crown Prince Mohammed bin Salman and announcing the removal of sanctions on Syria, citing MBS's request. Trump also revealed a $600 billion Saudi investment in the US and a $142 billion arms deal, while suggesting Iran should negotiate its nuclear program. Meanwhile, Senate Minority Leader Chuck Schumer is blocking DOJ nominees over concerns about Trump's acceptance of a luxury jet from Qatar. In domestic news, the Department of Homeland Security has terminated Temporary Protected Status for 9,000 Afghans, clearing the way for deportation. April's inflation report showed positive signs, with a 0.2% rise in CPI and the annual rate dropping to 2.3%. UnitedHealthcare's CEO resigned following a class-action lawsuit and financial fallout related to Medicare Advantage overcharges. Lastly, P Diddy's sex trafficking trial began, with his ex Cassie Ventura testifying about years of abuse and exploitation, alleging that her music career was sidelined for Diddy's personal demands. Resources/Articles mentioned in this episode: WA Post: Trump says U.S. will end sanctions on Syria ‘to give them a chance at greatness'  NBC News: Chuck Schumer says he is placing a hold on Trump DOJ nominees amid questions on Qatar's luxury jet gift Politico: DHS terminates temporary protected status program for Afghans  CNBC: Annual inflation rate hit 2.3% in April, less than expected and lowest since 2021  WSJ: UnitedHealth CEO Is Out, Sending Shares Plummeting NBC News: Cassie testifies at Diddy's sex trafficking trial of abuse and humiliation from 'freak offs' Morning Announcements is produced by Sami Sage and edited by Grace Hernandez-Johnson Learn more about your ad choices. Visit megaphone.fm/adchoices

Lee Camp gets into the Liberal media going nuts over Pentagon firings AND RFK Jr. outing Trump and his $100 Million from Big Pharma PLUS the truth about Zelensky! To get FREE help navigating Medicare and Medicare Advantage, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option. *Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

Lee covers the shocking deal between Trump and Hamas PLUS the many other ways Trump seems to be leaving Israel out of things. AND the shocking technological advancements in China that the US can't seem to stop. That and much more!To learn more about Chapter Medicare Advice, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

https://www.justice.gov/opa/pr/united-states-files-false-claims-act-complaint-against-three-national-health-insurance If you would like to work with Christian on your Medicare Health Plan, we currently work with people in 45 states. Those are the states we currently are licensed in. Christian and Christian Brindle Insurance Services represents many of the top insurance companies in the Medicare industry. Contact us for more information:➡️Our Site: https://https://www.christianbrindleinsuranceservices.com/ ✅Call (801)-255-5340.

What if the two most important questions in your practice— 'Is this financially viable?' and 'Am I doing the work I love?' — didn't have to compete? In this eye-opening episode, Jeremy dives deep into the strategic crossroads every private practice owner faces, especially when considering whether to take insurance, stay private pay, or explore a hybrid model. He breaks down the real numbers, state-by-state reimbursement differences, and the often-overlooked red flags in insurance relationships—like sneaky non-quantitative treatment limitations and the true cost of claim denials. You'll learn why Medicare Advantage's recent rate hike isn't as rosy as it seems, how chargebacks can be your secret diagnostic tool, and when it's time to DIY, outsource, or insource your billing. And perhaps most importantly, Jeremy challenges you to think bigger: to step into your role as CEO, shift your money mindset, and design a practice that serves both your clients and your bottom line. If you're weighing your next move in practice management, this episode is your roadmap. Resources Mentioned In This Episode  Read the show notes here Watch on YouTube  Use the promo code “GORDON” to get 2 months of Therapy Notes free Google Ads for Therapists Consulting with Gordon Mental Health Wear TN Meet Jeremy Zug Jeremy Zug has over a decade of experience in the healthcare industry. Jeremy is known for his expertise in insurance billing, and frequently writes and speaks on topics that support mental health professionals in achieving financial health and operational excellence. He co-founded Practice Solutions with his wife Kathryn in 2017, relying on their combined knowledge from private practices they had worked at while in college. Practice Solutions is an expanded medical billing company offering billing services, professional services, and educational resources to thousands of mental and behavioral healthcare providers for optimal revenue cycle management. Website LinkedIn Facebook Instagram Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance (20% off using this link!) Our insurance billing services are available at 15% off for the first three billing months. Sign up at https://www.practicesol.com/pot

Lee gets into the attack on Israel's airport that is turning Israel into a no-fly zone. Plus, why both India and Pakistan want war. AND much more!Lee Camp livestreams 3 days a week, and Unredacted Tonight comes out on Thursdays at 7pm ET. Make sure you don't miss an episode!Today's Sponsor: To get FREE help navigating Medicare and Medicare Advantage, call 757-349-8232 or go to AskChapter.org/Camp*Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and standalone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently, we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

Join Dr. Damon Arnold, retired U.S. Army combat medic and host of America's Heroes Group, as he speaks with Susan Jaffe, a contributing writer for KFF Health News and the DC Correspondent for The Lancet. In this compelling discussion, they delve into Jaffe's recent article, "When Hospitals Ditch Medicare Advantage Plans, Thousands of Members Get to Leave Too," published on April 28, 2025. Learn about the complex dynamics behind hospitals opting out of Medicare Advantage plans, the impact on beneficiaries, and the special enrollment periods that can provide relief.Topics:Overview of Medicare and Medicare Advantage PlansWhy Hospitals Leave Medicare Advantage NetworksThe Impact on Patients and ProvidersSpecial Enrollment Periods and Patient RightsDifferences Between Urban and Rural Access to CareHow to Navigate Medicare Advantage Plan ChangesLegislative Responses and Consumer AdvocacyResources for Affected Patients and Families

Lee Camp & Eleanor Goldfield reveal the truth behind Trump's new UNHINGED federal budget PLUS India's attack on Pakistan, the police again go after Columbia students, and US contractors being used WHERE?! All that and more!To get FREE help to navigate Medicare and Medicare Advantage, call 757-349-8232 or go to AskChapter.org/Camp*Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and standalone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently, we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

If you would like to work with Christian on your Medicare Health Plan, we currently work with people in 45 states. Those are the states we currently are licensed in. Christian and Christian Brindle Insurance Services represents many of the top insurance companies in the Medicare industry. Contact us for more information:➡️Our Site: https://https://www.christianbrindleinsuranceservices.com/ ✅Call (801)-255-5340.

A possible solution for menopause/post-menopause vaginal atrophyMedicare vs. medicare advantageMy doctor has me on three different blood pressure meds making me very tired every afternoon. Any suggestions?Wearable device heart rate zones

(This episode originally aired on October 22, 2024.) For years, the best word to describe Medicare Advantage (MA) was “untouchable.” Hugely popular among seniors, profitable for health plans—the hybrid public-private payment model grew to the point that it now covers more seniors than traditional Medicare. But in the past few years, the tide has started to change. And if you've been paying attention in recent months, you'll have seen headlines announcing that payers that are scaling back their MA offerings and providers are exiting MA contracts. The MA market has gone from “untouchable” to “volatile.” The question is: why is this happening, and what does it mean for payers, providers, and seniors moving forward? In this episode, hosts Rachel (Rae) Woods and Abby Burns invite health plan experts Max Hakanson and Chelsea Needham to dissect what is going on in MA and how plans and providers are—or should be—navigating the changing tide. Links: Ep. 203: Value series: Is the future of VBC in specialty care? Zing Health & Strive Health say yes. Ep. 149: Senior Care (Part 1): Specialized primary care for an aging population Ep. 150: Senior Care (Part 2): The rapid growth of Medicare Advantage 3 traits health plans want in a provider partner 4 traits providers want in a health plan partner Around the nation: CMS releases Medicare Advantage Star Ratings Q&A: Cardiologist Navin Kapur discusses the future of complex PCI

(This episode originally aired on October 22, 2024.) For years, the best word to describe Medicare Advantage (MA) was “untouchable.” Hugely popular among seniors, profitable for health plans—the hybrid public-private payment model grew to the point that it now covers more seniors than traditional Medicare. But in the past few years, the tide has started to change. And if you've been paying attention in recent months, you'll have seen headlines announcing that payers that are scaling back their MA offerings and providers are exiting MA contracts. The MA market has gone from “untouchable” to “volatile.” The question is: why is this happening, and what does it mean for payers, providers, and seniors moving forward? In this episode, hosts Rachel (Rae) Woods and Abby Burns invite health plan experts Max Hakanson and Chelsea Needham to dissect what is going on in MA and how plans and providers are—or should be—navigating the changing tide. Links: Ep. 203: Value series: Is the future of VBC in specialty care? Zing Health & Strive Health say yes. Ep. 149: Senior Care (Part 1): Specialized primary care for an aging population Ep. 150: Senior Care (Part 2): The rapid growth of Medicare Advantage 3 traits health plans want in a provider partner 4 traits providers want in a health plan partner Around the nation: CMS releases Medicare Advantage Star Ratings Q&A: Cardiologist Navin Kapur discusses the future of complex PCI

Lee Camp digs into the hidden side of the day's news. Israel is on fire for a hidden reason. Trump wants to reopen Alcatraz, and here's why that's insane. Plus much more!To get FREE help to navigate Medicare and Medicare Advantage, call 757-349-8232 or go to AskChapter.org/Camp*Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently, we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.