Medicare Advantage
publication date
Payer
Senators Urge for More Regulations on 'Unscrupulous' Medicare Advantage MarketingIn a letter to CMS, lawmakers highlight five steps they want the agency to take to counter deceptive practices.
Payer
Regence, MultiCare Implement Nation's First FHIR-Driven Prior Authorization Standard"Bringing pre-authorization to the point of care" reduces burden across stakeholders, notes one Regence executive.
Payer
Hospital-Payer Experience Worsening Due to Insurer Practices That Delay CareThe American Hospital Association (AHA) finds administrative policies are increasingly overburdening providers.
Payer
Medicare Advantage Markets Lack Competition, Dominated by Top PayersA study by the American Medical Association (AMA) highlights the consequences for patients and providers.
Payer
Lumeris Expands Medicare Advantage Plan into Five New StatesThe company is growing five-star rated Essence Healthcare to Indiana, Kentucky, Arkansas, Georgia, and Ohio.
Payer
DOJ sues Cigna for Medicare Advantage OverpaymentsThe Justice Department is intervening in a whistleblower lawsuit, first filed in 2017.
Payer
Key Factors Driving Enrollees to Medicare Advantage PlansMore benefits and a limit on out-of-pocket costs are the top reasons older adults are opting for Medicare Advantage (MA).
Payer
Bill Introduced to Prohibit Medicare Advantage Plans from Using Medicare in NameThe Save Medicare Act argues that Medicare Advantage (MA) plans are deceptive and overcharge seniors for profit.
Payer
Bright Health Exits Individual, Family Plan MarketsThe health insurer will also no longer offer Medicare Advantage plans outside of California and Florida.
Payer
Medicare Advantage Star Ratings Fall as Pandemic Provisions EndCMS released the 2023 star ratings for Medicare Advantage and Part D plans, with the average rating at 4.15.
Payer
Tracking Medicare Advantage's Upward Trajectory With Aetna's Terri SwansonAetna's vice president and head of Medicare Part D shares insights into Medicare Advantage's growth ahead of the annual enrollment...
Payer
HHS-OIG says Humana's MA Plan Overcharged $34.4MHumanaChoice says it 'strongly disagreed' with the audit, which found that 76% of claims 'were not supported in the medical...