UnitedHealth Eyes Recovery Amid Medicare Scrutiny and Rising Costs
UnitedHealth faces DOJ investigation and Medicare scrutiny amid rising medical costs, yet diversification through Optum supports potential recovery in 2025.
UnitedHealth Group Under Federal Scrutiny Amid Medicare Advantage Challenges
UnitedHealth Group faces federal investigations over Medicare Advantage practices amid rising scrutiny of private Medicare plans. Explore the implications for insurance regulation and healthcare market dynamics.
DOJ Sues Medicare Advantage Insurers for Kickback and Discriminatory Practices
The DOJ has filed a lawsuit against major Medicare Advantage insurers for an alleged kickback scheme and discriminatory enrollment practices affecting beneficiaries with disabilities. The case highlights regulatory issues and market conduct in private Medicare plans.
Federal Agencies Advance Healthcare Price Transparency with New RFIs and Guidance
U.S. federal agencies issue new guidance and requests for information to improve transparency in prescription drug and hospital prices, aiming to enhance data accuracy and compliance.
House Passes Budget Bill with Largest Medicaid Cuts and Significant Tax Reforms
House Republicans pass budget bill enacting largest Medicaid cuts in U.S. history, adding tax breaks for the wealthy and increased immigration enforcement funding. Impact on healthcare premiums and federal deficit noted.
CMS Amplifies Medicare Advantage RADV Audits and Targets Medicaid Provider Taxes
CMS plans major expansion of Medicare Advantage RADV audits and proposes rules to limit Medicaid provider taxation practices, impacting insurer compliance and Medicaid financing.
CMS Intensifies Medicare Advantage Audits, LTC Research Highlights, and Nursing Home Compliance Issues
CMS escalates Medicare Advantage audits targeting upcoding and overpayments; research shows benefits of closer heart failure patient monitoring to reduce rehospitalizations; federal probe into nursing home COVID policies; nursing home financial fraud uncovered.
Medicare and Medicaid Funding Cuts Threaten Care for Aging U.S. Population
Explore the implications of proposed Medicare and Medicaid funding cuts on older adults and underserved communities, highlighting the role of nursing leaders and the aging U.S. population's healthcare needs.
CMS Expands Medicare Advantage Audits Impacting Major Health Insurers
CMS expands Medicare Advantage audits from 2018-2024, intensifying compliance demands and financial scrutiny for major health insurers like UnitedHealth, CVS, and Humana.
CMS Excludes Obesity Drugs from Medicare Coverage Amid Cost Concerns
CMS excludes obesity drugs from 2026 Medicare coverage, citing cost concerns; Eli Lilly criticizes the decision impacting obesity management treatments.