A publicly accessible database powering CMS’ Medicare Advantage provider directory exposed Social Security numbers of healthcare providers, The Washington Post reported April 30. The Post downloaded the database and found dozens of provider Social Security numbers. The database had been accessible for…
Medicare Advantage
Alignment Healthcare reported first quarter revenue of $1.2 billion, a 33% increase from the same period last year, the company said April 30. Medicare Advantage membership reached approximately 284,800 at the end of the quarter, up 30.9% year-over-year. The insurer…
Centene is participating in CMS’ GLP-1 bridge program for Medicare Part D, CEO Sarah London said on an April 28 earnings call. Under the “Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth” model, CMS would leverage negotiated GLP-1 prices…
Humana will “adjust” Medicare Advantage benefits in 2027 as the gap between CMS funding and the cost of care has grown wider heading into this year’s bid cycle, company executives said April 29 during the insurer’s first-quarter earnings call. President…
HHS’ Office of Inspector General found CMS may have improperly paid more than $2.26 million for virtual check-in and e-visit services for Medicare enrollees, according to an April audit report. The audit window — which spanned Jan. 1, 2019, through…
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A House bill introduced April 20 by a bipartisan group of representatives, five of whom are also physicians, aims to tighten Medicare Advantage prior authorization timelines and impose stricter denial policies. “Medicare is a promise to America’s seniors that they…
Elevance Health has set aside $935 million to cover potential costs tied to its ongoing risk adjustment data dispute with CMS, which threatens the insurers’ ability to enroll new members into some of its Medicare Advantage plans. CFO Mark Kaye…
As a growing number of hospitals and health systems walk away from Medicare Advantage contracts, Cleveland Clinic is moving in the opposite direction, betting that the path forward runs through the payer’s side of the table, not away from it.…
CMS is holding off on its voluntary “Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth” model pilot for Medicare Part D, the agency confirmed to Becker’s April 21. Under BALANCE, CMS would negotiate lower GLP-1 prices for Medicaid programs…
UnitedHealthcare is considering participation in CMS’ voluntary “Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth” model, according to UnitedHealth Group’s April 21 earnings call. BALANCE involves negotiated lower GLP-1 prices for Medicaid programs and Medicare Part D plans, along…