For example, the No UPCODE Act, introduced by Senators Bill Cassidy (R-LA) and Jeff Merkley (D-OR), would eliminate the use of health risk assessments used to boost coding intensity and utilize two ...

Federal officials have a plan that could curb billions of dollars in overpayments to Medicare Advantage plans. But will they ...

The findings are “very depressing,” one commissioner said. Still, it’s a smaller sum than in 2025, thanks to the continued ...

Federal officials are targeting a trillion in Medicare Advantage overpayments impacting future premiums and benefits.

The proposal would eliminate the financial motivation insurers have to mine their members’ charts for additional diagnoses.

The Trump administration’s pay bump is not a cut to the program but rather a “right-sizing” of taxpayer-funded insurance, ...

Medicare Advantage (MA), Medicare’s popular system of private health plans, is in the hot seat. During a recent congressional hearing, members and witnesses expressed concern about MA plans’ efforts ...

1. In a 49-page opinion, the U.S. Court of Appeals for the District of Columbia Circuit reversed a 2018 decision that vacated Medicare’s overpayment rule, which requires insurers to refund payment to ...

On Nov. 6, CMS filed an appeal to a September judgment that overturned a 2014 overpayment rule for Medicare Advantage plans. 1. The 2014 overpayment rule concerns an ACA requirement that Medicare ...

Medicare scammers use spoofed caller IDs and fake authority to steal personal information, but real Medicare never calls asking for details.

Medicare Advantage health plans are blasting a government proposal this week that would keep their reimbursement rates flat next year while making other payment changes. But some health policy ...

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