Medicare Advantage
publication date
Finance
Centene Sells IlliniCare to CVS as Part of WellCare Merger
The sale includes Centene's Medicaid and Medicare Advantage plans in Illinois.
Finance
Humana Cuts $3.5B in Care Costs Through Medicare Advantage
The Louisville-based insurer's annual value-based care report found Medicare Advantage members are going to the hospital less often.
Strategy
Whistleblower Alleges Medicare Fraud At Iconic Seattle-Based Health Plan
Suit alleges that Group Health Cooperative claimed some patients were sicker than they were, and billed for medical conditions that...
Finance
Trump Speech Offers Dizzying Preview Of His Healthcare Campaign Strategy
The president took aim at the overhaul plans advocated by his Democratic opponents and claimed Republicans are committed to protecting...
Finance
KHN Files Lawsuit To Force CMS To Disclose Medicare Advantage Audits
KHN seeks copies of 90 government audits of Medicare Advantage health plans conducted for 2011, 2012 and 2013 but never...
Premiums for Medicare Advantage Expected to Drop 23% for 2020
HHS says MA plan options, benefits, and enrollment are expected in increase in the coming year.
Clinical Care
Prior Authorization Fixes Still a Medicare Priority, Says CMS Chief
Process needs to be less burdensome, Verma says
Finance
Humana Projects Additional 500K Medicare Advantage Members for 2019
Humana also reported $16.2 billion in total revenues, an increase of $2 billion year-over-year.
Strategy
Azar and Verma: Competition, Value-Based Models Needed to Fix Our Cost Problem
Both the HHS secretary and CMS administrator cited the competition among Medicare Advantage plans as a model of success.
HHS OIG Offers 25 Ways to Reduce Healthcare Waste and Fraud
OIG says these recommendations 'would most positively affect HHS programs in terms of cost savings, program effectiveness and efficiency, and...
Finance
Missouri Firm With Silicon Valley Ties Faces Medicare Billing Scrutiny
A recent HHS audit and a whistleblower lawsuit, have put Essence scrutiny. Medicare is conducting a separate audit.
Finance
Medicare Advantage Overbills Taxpayers By Billions A Year As Feds Struggle To Stop It
Officials have known for years that some Medicare Advantage plans overcharge for treating serious medical conditions they cannot prove their...