Humana backs legislative efforts to reform Medicare Advantage billing practices, focusing on diagnoses from nurse practitioner home visits to improve Medicare payment accuracy and reduce overpayments.
CMS Director Mehmet Oz launches intensified audits of Medicare Advantage plans targeting fraud, waste, and upcoding as enrollment grows. Stronger oversight aims to sustain Medicare's financial health.
Walmart introduces a first-of-its-kind AI-powered platform helping Medicare Advantage members maximize supplemental benefits on health and wellness products, streamlining benefit tracking and healthier shopping.
UnitedHealth Group's leadership transition and strategic review respond to Medicare Advantage reimbursement changes and regulatory scrutiny, affecting stock performance and future growth plans.
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.
