Health insurers are warning that flat Medicare Advantage rates, as proposed by the Trump administration late Monday, would likely force them to take a deep look at the benefits they offer. The news ...
On January 26, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year 2027 Advance Notice of Methodological Changes for Medicare Advantage (MA) capitation rates and Medicare ...
Sen. Chuck Grassley, R-Iowa, chairman of the Senate Committee on the Judiciary, has released a majority staff report that claims UnitedHealth is gaming the Medicare Advantage system and turning risk ...
The main difference between MedPAC and CMS estimates of uncorrected coding intensity is that MedPAC’s estimate accounts for the upward trend in coding intensity. The growth of the Medicare Advantage ...
Medicare Advantage insurers get a 0.09% payment increase for 2027 should the Advance Notice released on Monday be finalized. During an earnings call Tuesday morning, UnitedHealthcare CEO Tim Noel ...
Major insurers are gaming Medicare Advantage’s risk adjustment system to reap higher payments from the government, costing Medicare billions of dollars, according to a new analysis of CMS data.
The Centers for Medicare & Medicaid Services (CMS) published its “Advance Notice of Methodological Changes for Calendar Year (CY) 2027 for Medicare Advantage (MA) Capitation Rates and Part C and Part ...
Despite the delay in the final rule, Alignment CEO John Kao said it's clear that CMS is putting a focus on addressing risk adjustment misbehavior. (mohd izzuan/getty) Alignment Healthcare executives ...
Reintroducing Alzheimer disease and related dementias (ADRD) hierarchical condition categories (HCCs) into the Medicare Advantage (MA) risk-adjusted payment model was linked to improved care access ...
To attenuate the effects of diagnostic coding by Medicare Advantage (MA) plans—a practice that increases plan payments—beginning in 2024 the Centers for Medicare and Medicaid Services adjusted its ...
CMS is raising Medicare Advantage payments by 2.48%, or more than $13 billion, according to its finalized 2027 rate announcement. The agency said April 6 that when estimated risk score trends in MA ...
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