The Medicare open enrollment period and recent federal shutdown are driving increased scams targeting Medicare beneficiaries. Learn how confusion around Medicare cards heightens fraud risks.
FirstMedicare Direct will close operations by end of 2025, affecting 6,000 Medicare Advantage members. This exit highlights challenges in the Medicare Advantage insurance market.
CMS finalized the 2026 Medicare Physician Fee Schedule with minor reforms and introduced an interactive dashboard tracking payment rates across Medicare payment systems starting January 2026.
Medicare Advantage market pivots from growth-at-any-cost to profitability-first amid CMS regulatory tightening and rising medical costs. Key strategic shifts include operational efficiency, agility in member services, and investment in clinical programs to improve outcomes and reduce total care costs.
Explore essential insights into Medigap Plans F, G, and N, focusing on coverage, enrollment periods, and regulatory nuances critical for U.S. insurance professionals advising Medicare beneficiaries.
CVS Health closes 16 Oak Street Health locations citing elevated medical costs and CMS risk model changes, reflecting broader strategic shifts in retail healthcare amid financial pressures.
Ballad Health sues UnitedHealth Group over alleged Medicare Advantage care denials, coding practices, and reimbursement disputes impacting rural healthcare and insurance contracts.
Community paramedics and post-discharge monitoring reduce hospital readmissions and Medicare penalties, improving patient outcomes and cost efficiency in Minnesota hospitals.
A federal judge upheld CMS Medicare Advantage star ratings, resulting in a downgrade for Humana that risks billions in government bonus payments. The ruling affects nearly half of Humana's Medicare Advantage members and has broad implications for the insurer and Medicare market.
A federal report finds many Medicare Advantage and Medicaid managed care plans list inaccurate mental health providers, affecting access and compliance. Recommendations include using billing data and creating a national provider directory.
