News
Oversight shrinks Medicare Advantage payment gap to $76B: MedPAC
1+ day, 2+ hour ago (41+ words) Oversight shrinks Medicare Advantage payment gap to $76B: MedPAC'Modern Healthcare Oversight shrinks Medicare Advantage payment gap to $76B: MedPAC The gap between Medicare Advantage payments and traditional Medicare reimbursement has narrowed, largely because of the standard known as V28, MedPAC found....
Aetna to pay $118M to settle Medicare Advantage upcoding claims
3+ day, 3+ hour ago (37+ words) Aetna to pay $118M to settle Medicare Advantage upcoding claims'Modern Healthcare Aetna to pay $118M to settle Medicare Advantage upcoding claims Health-related questions are the most popular topic among individuals using Microsoft's Copilot on mobile devices....
Medicare Ambulatory Specialty Model sparks pay concerns
3+ day, 15+ hour ago (33+ words) Medicare Ambulatory Specialty Model sparks pay concerns'Modern Healthcare Medicare Ambulatory Specialty Model sparks pay concerns The Medicare Ambulatory Specialty Model aims to improve identification and management of heart failure and lower back pain....
Insurers renew promises that a rebound is just around the corner
3+ week, 3+ day ago (113+ words) Health insurance executives are doing all they can to convince investors that good times are ahead. Medicare Advantage enrollment 2026: Winners and losers By: Nona Tepper, Kevin Davis How Intermountain saved $1B " and why more cuts are ahead Intermountain Health has reduced…...
Insurers issue dire warnings about Medicare Advantage pay rule
1+ week, 4+ day ago (38+ words) Insurers issue dire warnings about Medicare Advantage pay rule'Modern Healthcare Insurers issue dire warnings about Medicare Advantage pay rule Tech companies providing autism care are feeling the pressure from these cost containment efforts by public and private insurers....
Insurers back Medicare coding rule ahead of looming pay overhaul
1+ week, 5+ day ago (37+ words) Insurers back Medicare coding rule ahead of looming pay overhaul'Modern Healthcare Insurers back Medicare coding rule ahead of looming pay overhaul Former UVA Health CEO Dr. K. Craig Kent filed a lawsuit seeking $42 million in damages....
Blue Cross Michigan reduces losses under cost-cutting program
1+ week, 5+ day ago (43+ words) Blue Cross Blue Shield of Michigan reported a $246 million loss last year on revenue of $43.3 billion Blue Cross Michigan reduces losses under cost-cutting program Former UVA Health CEO Dr. K. Craig Kent filed a lawsuit seeking $42 million in damages....
CMS to freeze Elevance Health Medicare Advantage enrollment
1+ week, 4+ day ago (33+ words) CMS to freeze Elevance Health Medicare Advantage enrollment'Modern Healthcare CMS to freeze Elevance Health Medicare Advantage enrollment Former UVA Health CEO Dr. K. Craig Kent filed a lawsuit seeking $42 million in damages....
How CMS plans to transform the health insurance exchanges
2+ week, 2+ day ago (33+ words) How CMS plans to transform the health insurance exchanges'Modern Healthcare News How CMS plans to transform the health insurance exchanges The first step is withholding $259 million in funding to Minnesota's Medicaid program....
Medicare Advantage enrollment 2026: Winners and losers
3+ week, 3+ day ago (80+ words) Medicare Advantage enrollment 2026: Winners and losers'Modern Healthcare Medicare Advantage enrollment 2026: Winners and losers - Medicare Advantage enrollment totaled 35.5 million as of Feb. 1, a 3.2% increase from a year ago. - UnitedHealthcare, Elevance Health, Aetna and Centene decreased their memberships, while Humana gained beneficiaries....