Category: Health & Wellness

New Legislation Aims to Prevent Falls and Decrease Opioid Usage in Older Adults

BY TOG Network Solutions | Jun 26, 2024

Among those 65 and older, the Centers for Disease Control reports falls are the leading cause of injury deaths and responsible for nearly 3 million emergency department visits each year.…

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The Two-Midnight Rule: Additional Changes Expected for Medicare Advantage Members

BY TOG Network Solutions | Jun 13, 2024

This year is bringing even more changes for Medicare Advantage (MA) plans. One of the predominant adjustments is that MA plans will now follow the two-midnight rule. This means members’…

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The Medicare Advantage Playbook for 2025: New Rules, New Opportunities

BY TOG Network Solutions | May 16, 2024

In early April, the Centers for Medicare and Medicaid Services (CMS) finalized the 2025 Medicare Advantage Rule. This legislation also included changes to Medicare Part D, which covers prescription medications.…

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Medicare Advantage Spending Surge: What the 2023 Data Reveals & What Your Health Plan Needs to Know

BY TOG Network Solutions | May 15, 2024

A review of last year’s data shows a spike in service utilization for members with Medicare Advantage (MA) plans in 2023. This information came from an AHIP survey, which found…

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Inaccurate Reports of Vaping History Impacting Health Insurance Premiums

BY TOG Network Solutions | Apr 17, 2024

Vaping has been highly criticized due to its negative health effects, especially as the Food and Drug Administration (FDA) has cracked down on banning flavored e-cigarette products. As vaping use…

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Proposed Federal Legislation Intended to Expedite Prior Authorization Approval Process

BY TOG Network Solutions | Apr 15, 2024

Recent legislation proposed by the Biden administration aims to address member dissatisfaction with insurance approval wait times. If passed, this rule will apply to prior authorization requests through government insurance…

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