Adjusted estimates of the cost implications of projected Medicare Advantage growth are lacking and essential to discussions ...

As Medicare Advantage (MA) enrollment continues to surge, home health providers have seen slim margins deteriorate further.

CMS will hire nearly 2,000 coders to conduct audits to confirm diagnoses used for payment are backed by medical records.

Cai, lead author of the Mass General Brigham study, says, “Medicare Advantage plans receive more money per beneficiary than ...

Beginning in 2014, the Centers for Medicare & Medicaid Services (CMS) has permitted Medicare Advantage insurers to offer ...

New bipartisan bill would streamline prior authorization in Medicare Advantage, improving care access for older Americans.

UnitedHealth Group said 2025 revenue at Optum would be $10 billion less than previously estimated. Now the company is saying ...

The Trump administration plans to expand government audits of private Medicare health plans, adding more scrutiny to an ...

related to the Medicare Advantage (MA) program and MA data. The letter explains how existing gaps in MA reporting requirements fail to serve the needs of researchers, policymakers, regulators ...

Medicare Advantage and Part D Final Rule (Final Rule). With CMS releasing the 2026 Medicare Advantage and Part D Proposed ...

A Part D plan might also update its formulary if a new medication has become available or new data arises about ... medication and healthcare needs. Medicare Advantage plans might have network ...