CMS Expands Medicare Advantage Audits to Address $43B Overpayments
CMS is intensifying Medicare Advantage audits to recover $43 billion in overpayments, impacting provider contracts and regulatory compliance across the MA ecosystem.
Longevity Health Extends Humana Partnership to 2030 for ISNP Expansion
Longevity Health and Humana extend partnership through 2030 to expand Medicare Institutional Special Needs Plans with value-based care models in skilled nursing and senior living facilities.
Hospice Industry Faces Regulatory and Medicare Advantage Integration Challenges in 2025
Hospices confront rising operational costs, increased audits, and potential Medicare Advantage coverage changes in 2025, impacting hospice care delivery and financial sustainability.
SCAN Wins 2025 Hearst Health Prize for Innovative Medicare Advantage Care Platform
SCAN received the 2025 Hearst Health Prize for its PATH platform, enhancing home-based primary care with data integration and risk stratification for Medicare Advantage seniors.
Key Medicare Reforms in Proposed Domestic Policy Bill Impact Payments and Coverage
Discover how proposed domestic policy legislation may reduce Medicare payments, expand HSA eligibility for employed seniors, and enhance rural hospital designations, reshaping Medicare coverage and funding starting 2026.
UnitedHealth CEO Replacement Follows Medicare-Related Financial Challenges
UnitedHealth replaced CEO Andrew Witty after financial challenges related to Medicare coverage led to profit declines and withdrawn guidance, highlighting regulatory and cost pressures in the insurance market.
UnitedHealth Group Faces Financial Challenges Amid Medicare Cost Pressures
UnitedHealth Group reported financial setbacks in 2025 due to Medicare cost pressures and regulatory changes, prompting leadership shifts and raising stock outlook discussions.
U.S. Rep. Hinson Addresses Medicare Reimbursement and Workforce Challenges in Rural Health
U.S. Representative Ashley Hinson discusses improving Medicare reimbursement and addressing workforce shortages in rural health clinics during a roundtable at Emplify Health by Gundersen.
Medicare Billing Accuracy and Fraud Risks in Physical Therapy Claims
Insights into Medicare billing accuracy and fraud risks in physical therapy claims, emphasizing the necessity of compliance to prevent false billing and regulatory issues.
Evolving Property Insurance Strategies Amid Increasing Catastrophic Risks
The U.S. property insurance market is adapting to rising catastrophic losses with refined underwriting, reliance on the E&S market, and enhanced risk mitigation strategies.