Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...
In the largest Medicare Advantage fraud settlement to date, Oakland, Calif.-based Kaiser Permanente agreed to pay $556 million to resolve allegations it violated the False Claims Act by submitting ...
The Trump administration has released proposed payment rates in Medicare Advantage (MA) and Part D for the 2027 plan year, ...
The proposal would eliminate the financial motivation insurers have to mine their members’ charts for additional diagnoses.
For healthcare executives, the proposed MA changes reinforce a growing disconnect between CMS policy goals and provider experience. Even as CMS seeks to rein in plan behavior, providers remain the ...
The proposed 2027 Medicare Advantage payment update suggests a minimal 0.09% increase, affecting insurer stock prices and financial outlooks. Proposed Medicare Advantage payment updates spark concern ...
CMS released its 2027 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies, proposing a net average year-over-year payment ...
Medicare Advantage is the dominant Medicare delivery system, now covering 54% of all Medicare enrollees. With the increase in enrollment and federal spending, however, has come increased scrutiny from ...
16don MSN
Report: UnitedHealth Group used 'aggressive tactics' in Medicare Advantage risk assessments
A Senate report accuses UnitedHealth Group of turning Medicare Advantage risk adjustments into a profit strategy.
Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with Penguin Ai's HCC Coding & Risk Adjustment Snowflake Native App PALO ALTO, Calif., Jan.
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