UnitedHealth Group Under DOJ Investigation for Medicare Advantage Practices
UnitedHealth Group faces DOJ investigation over Medicare Advantage billing practices, impacting insurer compliance and reimbursement within Medicare programs.
DOJ Investigates UnitedHealth Group Over Medicare Advantage Practices
UnitedHealth Group faces DOJ investigation over Medicare Advantage practices, with the insurer cooperating amid leadership changes and cost pressures. The inquiry centers on coding and managed care compliance.
Physician Exit Rates from Medicare Fee-For-Service Rise, Impacting Primary Care Access
Study reveals rising physician exit rates from Medicare fee-for-service, with primary care facing notable impact amid payment and administrative challenges.
2025 U.S. Senior Health Insurance Options Beyond Medicare and Medicaid
Explore the diverse health insurance options available to U.S. seniors in 2025 beyond traditional Medicare and Medicaid. Learn about Medicare Advantage, Medigap, VA benefits, TRICARE, PACE, and private plans.
Congressional Criticism of Medicare Funding Cuts in Recent Bill
Congressman Vicente Gonzalez criticizes recent Medicare funding cuts in a newly passed bill, highlighting potential impacts on seniors and the insurance industry.
Rising Medical Costs and Regulatory Issues Challenge U.S. Health Insurers
U.S. health insurers face financial pressures from rising Medicare Advantage costs, increased healthcare utilization, and regulatory debates over physician payments and drug pricing, impacting premiums and provider networks.
CMS and Insurers Launch AI-Driven Medicare Prior Authorization Reforms
CMS introduces WISeR model using AI to expedite Medicare prior authorizations while insurers enhance processes to cut waste and improve care approval speeds.
CMS Proposes Key Medicare Part B Pricing and Reporting Updates for 2026
CMS's 2026 proposed rules for Medicare Part B include major updates to average sales price calculations, Inflation Reduction Act compliance, ASP documentation, and Medicare inflation rebates affecting government pricing.
Eye Consultants of Pennsylvania Settles for $790K Over Medicare Billing Violations
Eye Consultants of Pennsylvania agrees to $790,000 settlement over False Claims Act violations involving Medicare E&M billing irregularities. Federal enforcement underscores commitment to Medicare compliance.
CMS Narrows Medicare Custody Definition to Expand Coverage Access in 2025
CMS finalized a 2024 rule narrowing Medicare custody to physical confinement, expanding Medicare coverage for community-supervised individuals starting 2025.