AHIP highlights risks to Medicaid coverage and individual market stability in the Senate Finance Committee's budget reconciliation proposal, urging Congress to preserve affordable access and competition.

U.S. Senate Republicans are reviewing Medicare Advantage upcoding practices to reduce federal spending and support tax cut proposals, focusing on reforming provider payment inflation.

A California physician was sentenced for a $1.5 million Medicare home health care fraud involving false certifications and fraudulent billing. The case underscores critical compliance challenges in Medicare billing processes.

Medicare loses $60 billion annually to fraud, impacting beneficiaries' health and the program's finances. Senior Medicare Patrol leads prevention education during Medicare Fraud Prevention Week.

Recent IRS regulations on 831(b) micro-captive insurance companies have raised compliance and enforcement concerns, prompting calls for regulatory reform to better align IRS actions with congressional intent and protect small businesses.

MedPAC calls for federal reform of nursing home Five-Star ratings, emphasizing staffing and alternative quality metrics to improve long-term care under Medicare.

Medicare Advantage plans cost taxpayers 22% more per enrollee than traditional Medicare. Understanding payment system flaws and reform options is critical for policymaker and insurer strategy.

Boone Health signs a 4-year contract extension with Anthem Blue Cross Blue Shield in Missouri, securing network access for members. MU Health Care remains out of network after contract talks stall.

Mercy and Humana collaborate to open 65 Prime+ clinics in Missouri, enhancing Medicare senior care with tailored primary care services and expanded access to Medicare Advantage plans.

Bipartisan report reveals organ transplant rating loophole; UnitedHealth faces Medicare Advantage scrutiny; labor rules for home health aides under review; CVS and Cigna settle executive lawsuit.