6+ hour, 4+ min ago  (352+ words) Congressional scorekeepers expect the Hospital Insurance trust fund to run dry more than a decade earlier than they previously expected, after the Republican megabill'slashed the revenues it receives. The HI trust fund pays for benefits in Medicare Part A, including…...

7+ hour, 35+ min ago  (837+ words) A Healthcare Dive analysis of new government data lays out just how drastically insurers retrenched their MA businesses for 2026. Medicare Advantage growth continues to slow as health insurance giants pull back on the program, rattled by shrinking profits. Almost 35.5 million…...

1+ week, 6+ day ago  (790+ words) New membership expectations for 2026 leave Humana and UnitedHealth neck and neck when it comes to MA enrollment, though Humana's growth is a significant gamble at a time of elevated medical spending. Humana expects to grow its Medicare Advantage membership by…...

2+ week, 6+ day ago  (1095+ words) The agency quietly released a memo updating MA plans on how it's approaching risk adjustment data validation audits after a Texas judge's ruling last year complicated the expanded reviews. The CMS has provided a long-awaited update on how it plans…...

3+ week, 7+ hour ago  (351+ words) Nearly 53 million prior authorization requests were sent to insurers in 2024, compared with nearly 50 million in the prior year, according to KFF. Nearly all MA enrollees are subject to prior authorization " where providers have to receive an insurers" approval before offering…...

4+ week, 3+ hour ago  (631+ words) Medicare director Chris Klomp said the Trump administration is "massively" in support of MA as health insurers cry foul over the meager'rate update. The Trump administration's top Medicare official is coming to the defense of the 2027 Medicare Advantage rate notice,…...

4+ week, 7+ hour ago  (1024+ words) The Trump administration has taken a big step toward curbing Medicare Advantage overpayments, proposing a rule that would stamp out one strategy insurers use to inflate their members" sicknesses to get higher reimbursement in the privatized Medicare program. In a…...

1+ mon, 1+ week ago  (1052+ words) The findings are "very depressing," one commissioner said. The federal government will pay an estimated $76 billion more to cover Medicare Advantage seniors this year than it would if those same seniors were in traditional Medicare, according to new estimates from…...

1+ mon, 1+ week ago  (235+ words) The Justice Department claims some Kaiser health plans submitted invalid diagnostic codes to reap higher reimbursement from Medicare. In MA plans, the federal government reimburses private payers a fixed monthly amount for managing the care of seniors enrolled in their…...

1+ mon, 1+ week ago  (896+ words) Staffers for Sen. Chuck Grassley, R-Iowa, dove into 50,000 pages of documentation from UnitedHealth for the new report, which accuses the company of maintaining a workforce dedicated to upcoding. UnitedHealth is aggressively gaming Medicare Advantage to inflate its reimbursement from the…...