Author: Rylee Wilson

Geisinger Health Plan received $6.5 million in Medicare Advantage overpayments in 2016 and 2017, according to an audit from HHS' Office of the Inspector General. 

A startup integrating Western medicine and Eastern wellness benefits in Medicare Advantage clinched $41 million in a funding round led by Google Ventures. 

Medicare Advantage plans should be aware of fraudsters turning their efforts to private plans, HHS' Inspector General Christi Grimm said. 

Humana's longest-serving director, David Jones Jr., is planning to retire after 30 years on the company's board, WDRB reported March 20. 

Payers and some provider groups are pushing back on a slate of proposed Medicare Advantage regulatory changes from CMS. Here are nine updates about the program Becker's has reported since March 7. 

CMS laid out more details on how it plans to implement the first-ever negotiation process of drug prices under Medicare, which will first apply in 2026.

Bright Health Group's board of directors includes leaders from venture capital, managed care and health systems. 

As CMS prepares to implement tougher risk adjustment data validation audits in Medicare Advantage, payers and providers can take steps to boost their compliance efforts. 

Oscar Health has appointed Sean Martin, MD, as chief medical officer. 

Shawn Fitzgibbon, former senior vice president at Bright Health Group and president of Bright Health subsidiary NeueNetworks, has joined healthcare consulting firm BDC Advisors.