Medicare Advantage

Latest Headlines

Latest Headlines

In past eight months, 15K MA enrollees granted special enrollment periods

Federal officials have allowed more than 15,000 Medicare Advantage members to use special enrollment periods to change plans or join traditional Medicare in the last eight months because of "significant" provider cuts in their plans' networks.

Hearing hashes out pros, cons of Medicare Advantage's growing role

At a congressional hearing about ensuring the fiscal stability of the Medicare program, experts and lawmakers discussed the role Medicare Advantage plans have played in altering how Medicare operates--and what role they should play in the future.

Medicare Advantage beneficiaries have fewer preventable hospitalizations

Medicare Advantage beneficiaries experience fewer avoidable hospitalizations than those enrolled in traditional fee-for-service Medicare plans, suggesting that MA plans may be more effective at coordinating preventive care, according to a new study.  

Five Medicare payment recommendations from MedPAC

The Medicare Payment Advisory Commission's annual report offers five payment recommendations including reforms for two post-acute care providers, a 10 percent cut to drug payments for safety-net hospitals and changes to Medicare Advantage diagnosis coding.  

Cigna gets win from CMS policy shift, but consumers may lose

Federal regulators' decision to revise how star ratings are deducted from sanctioned Medicare Advantage plans will preserve millions of dollars in quality bonuses for Cigna--but some consumer advocates say the shift undermines health plans' accountability,  Kaiser Health News  reports.  

CMS revises policy on docking star ratings of sanctioned Medicare Advantage plans

Federal regulators have revised their policy for automatically reducing star ratings for Medicare Advantage and Part D plans operating under immediate sanctions, a decision that will benefit health plans that have been hit by enforcement actions.

Report: Divestitures in Aetna-Humana merger won't help Medicare Advantage competition

Divestitures made during a previous healthcare insurance merger did little to maintain competition among Medicare Advantage plans, reaffirming concerns that the Aetna-Humana merger will increase premiums for seniors and lead to higher costs within the Medicare program, according to a new report from the Centers for American Progress.

CMS ramps up enforcement of Part C, Part D Medicare plan violations

A recently released list of financial penalties imposed on Medicare Part C and Part D plan sponsors shows that the government is increasingly coming down hard on health plans that violate federal regulations.  

CMS changes will cut Medicare Advantage payments, report says

Recently proposed changes to Medicare Advantage payment rules will result in an estimated 0.5 to 3.9 percent cut on average to MA payments in 2017, according to a new report.  

Doctor accuses Humana of encouraging Medicare Advantage fraud

A recently unsealed lawsuit suit claims Humana encouraged physicians to elevate patient conditions in an effort to inflate Medicare Advantage risk scores, and then turned a blind eye when one physician voiced concerns, according to a report jointly published by the Center for Public Integrity and  NPR.