The largest Medicare Advantage insurers are backing reforms to the program, and lawmakers are drafting new legislation targeting MA.
Here are 10 Medicare Advantage developments Becker’s has reported since May 28.
- A bipartisan group of lawmakers is introducing legislation that would allow the Department of Veterans Affairs to bill Medicare Advantage plans for care provided to members, according to the Wall Street Journal. A study published in Health Affairs in November found Medicare Advantage plans were paid more than $1 billion for veteran enrollees who did not use any Medicare services.
- CMS is raising limits for payments to Medicare Advantage brokers. In 2026, plans can pay brokers up to $694 for new enrollments in MA plans and $347 for renewing existing members. These amounts are higher in Connecticut, Pennsylvania, New Jersey, California and the District of Columbia.
- New York City will not implement an Aetna Medicare Advantage plan for its retirees, Mayor Eric Adams said. Mr. Adams said he heard concerns from retirees about the plan at numerous town halls and events.
- Walmart partnered with Soda Health to launch the Walmart Everyday Health Signals program, aimed at helping Medicare Advantage and Medicaid enrollees make healthier food choices through personalized guidance based on online shopping patterns.
- A jury found a former Medicare Advantage executive not guilty of healthcare fraud. The case was a rare criminal prosecution of Medicare Advantage fraud.
- UnitedHealthcare is ending broker commission payments for some of its Medicare Advantage plans beginning July 1.
- The federal government will spend an estimated $86 billion on Medicare Advantage supplemental benefits in 2025, according to a report from the Medicare Payment and Advisory Commission.
- Coventry Health and Life Insurance Co., an Aetna subsidiary, received an estimated $6.9 million in Medicare Advantage overpayments, an audit published by HHS’ Office of Inspector General found.
- The country’s largest Medicare Advantage carriers are backing significant proposed reforms to billing practices, along with new crackdowns and audits of the plans. UnitedHealth Group said it supports efforts by CMS to audit every Medicare Advantage plan for potential overpayments annually. Humana is backing reforms aimed at reducing billing practices that result in billions of extra payments to the broader industry.
- Walmart is launching new digital offerings that will integrate with Medicare Advantage supplement plans.
