Nearly 53 million prior authorization requests were sent to insurers in 2024, compared with nearly 50 million in the prior year, according to KFF. Almost 8% of those requests were partially or fully ...
CMS proposes nearly flat Medicare Advantage payments for 2027, with a 0.09% increase and updated risk adjustment policies.
The Centers for Medicare & Medicaid Services (CMS) issued a revised memo Wednesday to strengthen the Special Focus Facility ...
Last year, the Centers for Medicare & Medicaid Services (CMS) made changes to its reporting rules, Section 111, specifically as it relates to ...
On July 15, 2025, the Centers for Medicare & Medicaid Services (CMS) released an Audit and Enforcement Report summarizing its annual Medicare Advantage (Part C) and Prescription Drug (Part D) program ...
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UnitedHealth upcoded Medicare Advantage claims to get more $$, Senate report says
"UHG appears to be gaming the system," says Sen. Chuck Grassley ...
A review by the Office of Inspector General has found little improvement in CMS’ reporting of adverse actions for providers since the OIG made a recommendation in 2010 to improve the reporting process ...
Insurers offering Medicare Advantage and Medicare prescription drug plans were fined more money in the first four months of this year than in the past four years combined, according to a Healthcare ...
A Senate report released Tuesday alleges that UnitedHealth Group is gaming the Medicare Advantage system to reap massive payments.
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