Government documents show that federal regulators rarely warn plans that their networks of health providers are so skimpy ...

In late 2024, the Centers for Medicare and Medicaid Services previewed a significant revision to the risk-adjustment model ...

CMS issued part one of its proposed 2022 Medicare Advantage Advance Notice, which updates payment methodologies to Medicare Advantage and Part D plans. 1. CMS released the first part of the proposed ...

Open enrollment for Medicare goes from Oct. 15 to Dec. 7 each year, when Medicare beneficiaries choose their coverage for the next plan year. As Medicare enrollees contemplate their choices for 2022, ...

Medicare Advantage insurers fully or partially denied 7.4% of prior authorization requests in 2022, an increase compared to the previous three years, according to an analysis by health policy research ...

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced [1] an aggressive plan (Plan) to expand its efforts to address fraud, waste, and abuse in Medicare Advantage (MA). By ...

A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars — only to abruptly back off amid an “uproar” ...

MIAMI--(BUSINESS WIRE)--HealthSun Health Plans today announced that the Centers for Medicare & Medicaid Services (CMS) awarded its Medicare Advantage plans a 5-Star rating for the fifth year in a row, ...