A new Medicare Advantage advocacy organization has emerged with the backing of several major health systems, adding more provider voices to the increasingly crowded debate over the future of the public-private program. The Alliance for Medicare announced its launch this…
Medicare Advantage
A federal judge has sided with the Justice Department in its bid to depose a former senior executive at Elevance Health over allegations that the insurer submitted fraudulent Medicare Advantage claims to the government. On May 20, the judge ordered…
President Donald Trump’s portfolio managers traded seven health insurers’ stocks as 2027 Medicare Advantage payment policies were being ironed out. The U.S. Office of Government Ethics released disclosures in May laying out thousands of trades in the first three months…
Medicare beneficiaries enrolled in Part D plans offered by vertically integrated insurers paid lower monthly premiums but higher out-of-pocket drug costs compared to enrollees in other plans, according to a May 19 analysis from the HHS Office of Inspector General. …
CarolinaEast Medical Center, a 350-bed hospital in New Bern, N.C., will drop Blue Cross Blue Shield and UnitedHealthcare Medicare Advantage plans, effective July 1, citing burdensome payment policies, claim denials and reimbursement delays. The hospital issued termination notices to both…
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A departing senior Elevance Health executive is pushing back against demands from the Justice Department to depose him in a Medicare Advantage fraud lawsuit against the insurer that stretches back several years. On May 6, Elevance asked a New York…
Park Ridge, Ill.-based Clear Spring Health will exit the Medicare Advantage market entirely on June 1, discontinuing its remaining business across Illinois, Georgia, and Colorado. The insurer, founded in 2017, had more than 12,000 members enrolled in its MA plans…
CMS has fined 13 health plans a combined $1.5 million for Medicare Advantage program violations spanning cost-sharing rules and Part D drug benefit administration. The penalties, issued May 1, stem largely from claims processing system errors that caused enrollees to…
CMS plans to fine Health First Health Plans $43,546 for failing to properly administer Medicare’s Part D transition supply policy, according to an April 29 notice from the agency. The insurer, part of the Rockledge, Fla.-based health system, had a…
CMS is imposing a $48,833 fine against a Providence PACE organization in Napa, Calif., according to an April 29 notice from the agency. The penalty was issued to Collabria Care, the name under which Providence Community Health Napa Valley holds…