Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...
In the largest Medicare Advantage fraud settlement to date, Oakland, Calif.-based Kaiser Permanente agreed to pay $556 million to resolve allegations it violated the False Claims Act by submitting ...
CMS has proposed a smaller than expected increase in Medicare Advantage payment rates for the upcoming plan year. The ...
The Trump administration has released proposed payment rates in Medicare Advantage (MA) and Part D for the 2027 plan year, ...
The proposal would eliminate the financial motivation insurers have to mine their members’ charts for additional diagnoses.
The proposed 2027 Medicare Advantage payment update suggests a minimal 0.09% increase, affecting insurer stock prices and financial outlooks. Proposed Medicare Advantage payment updates spark concern ...
Medicare Advantage is the dominant Medicare delivery system, now covering 54% of all Medicare enrollees. With the increase in enrollment and federal spending, however, has come increased scrutiny from ...
On January 14, the Department of Justice (DOJ) announced that five Kaiser Permanente affiliates agreed to pay $556 million to ...
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Report: UnitedHealth Group used 'aggressive tactics' in Medicare Advantage risk assessments
A Senate report accuses UnitedHealth Group of turning Medicare Advantage risk adjustments into a profit strategy.
George Witwer, CEO of Cavo Health Outperforms Machine Learning Tools with 96%+ HCC completeness, 2–4x Productivity Gains and Reduced Audit Risk Our platform delivers more accurate, audit-ready results ...
Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with Penguin Ai's HCC Coding & Risk Adjustment Snowflake Native App PALO ALTO, Calif., Jan.
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