UnitedHealth Group's former CEO Andrew Witty retires following financial setbacks and leadership transition. CEO Stephen Hemsley initiates independent reviews of risk adjustment and managed care practices.

Explore how AI innovations and the No UPCODE Act seek to resolve Medicare Advantage coding controversies, improving risk adjustment and compliance.

UnitedHealth Group's CEO responds to Q1 earnings miss driven by Medicare Advantage medical cost surges and DOJ scrutiny, outlining reforms to manage rising care expenses and rebuild investor confidence.

CMS is intensifying Medicare Advantage audits to recover $43 billion in overpayments, impacting provider contracts and regulatory compliance across the MA ecosystem.

Hospices confront rising operational costs, increased audits, and potential Medicare Advantage coverage changes in 2025, impacting hospice care delivery and financial sustainability.

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.

The 2025 decline in Medicare Advantage Star Ratings intensifies regulatory scrutiny. Black Book Research reveals health IT strategies top plans use to boost quality, member experience, and compliance across all payers.

The DOJ has filed a False Claims Act complaint against GoHealth, alleging illegal kickbacks to brokers for Medicare Advantage enrollments, triggering a securities investigation and stock decline.

UnitedHealth faces DOJ investigation and Medicare scrutiny amid rising medical costs, yet diversification through Optum supports potential recovery in 2025.

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.