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 ...

The Trump administration has released proposed payment rates in Medicare Advantage (MA) and Part D for the 2027 plan year, ...

Explore 2025 managed care enforcement trends under the Trump administration. Learn about Department of Justice (DOJ) and ...

CMS released its 2027 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies, proposing a net average year-over-year payment ...

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 ...

On a day when health insurers were reeling from the Trump administration proposing minimal increases to Medicare Advantage (MA) rates next year and a tightening of risk adjustment rules, a top CMS ...

For healthcare executives, the proposed MA changes reinforce a growing disconnect between CMS policy goals and provider experience. Even as CMS seeks to rein in plan behavior, providers remain the ...

A Senate report accuses UnitedHealth Group of turning Medicare Advantage risk adjustments into a profit strategy.

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