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

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 ...

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

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, ...