In 2025, the SSA notified over 850,000 ZIP codes about Medicare Extra Help and Medicare Savings Programs, emphasizing eligibility criteria and benefits available to reduce beneficiaries' out-of-pocket costs on prescription drugs and medical expenses.
Analysis shows rising exits of primary care physicians from Medicare fee-for-service, highlighting access challenges for older adults and shifts to Medicare Advantage and direct primary care models.
Maine Senator emphasizes the importance of Medicare Advantage for seniors and disabled Americans, noting a 5% payment increase for 2026 to reverse prior cuts and improve healthcare access, especially in rural areas.
UnitedHealth Group is cooperating with DOJ investigations into its Medicare Advantage practices, emphasizing compliance and initiating third-party reviews. Independent CMS audits and court rulings support UnitedHealth's adherence to Medicare regulations.
ASCs face increasing delays and denials from payers impacting revenue cycles. Increased scrutiny on device/pharma claims and contract carve-outs prompt ASC contract renegotiations amid Medicare Advantage changes.
Starting in 2025, Medicare prescription drug plans will have a new $2,000 out-of-pocket cap under the Inflation Reduction Act, eliminating the donut hole and lowering costs for beneficiaries. This applies to both Part D and Medicare Advantage plans with drug coverage.
UnitedHealth Group is cooperating with federal investigations into its Medicare Advantage billing practices amid scrutiny over diagnosis-based payments. The insurer faces civil and criminal probes amid increased healthcare utilization and financial pressure.
UnitedHealth Group is under federal criminal and civil investigation for Medicare Advantage billing practices amid financial pressures and leadership changes. The company cooperates fully and maintains confidence in compliance.
Learn about Special Needs Plans (SNPs), Medicare Advantage plans tailored for individuals with chronic conditions or dual Medicaid eligibility, covering special benefits and care coordination.
UnitedHealth Group faces DOJ investigation over Medicare Advantage billing practices, impacting insurer compliance and reimbursement within Medicare programs.
