For insurers that remain committed to their Medicare Advantage businesses, special needs plans have been a major growth driver. KFF estimated that almost half of MA enrollment growth from 2024 to 2025 stemmed from these tailored plans. In 2025, SNPs…
Medicare Advantage
Pennsylvania has opened a special enrollment window for 5,400 UnitedHealthcare Medicare Advantage members affected by the contract dispute with Allentown-based Lehigh Valley Health Network, giving impacted beneficiaries until April 30 to switch plans. The state said March 16 that it…
HSS’ Office of Inspector General estimates that BCBS Alabama received at least $7 million in Medicare Advantage overpayments, according to a March audit report. From a sample of 271 enrollee-years, 247 had medical records that did not align with diagnosis…
About 82% of the more than 16,000 available public comments on the 2027 Medicare Advantage proposed rate notice share the perspective and language of a letter from the Medicare Advantage Majority, a group with undisclosed funding sources and founders, according…
Anthem Blue Cross Blue Shield and UnitedHealthcare offer the best mobile provider search tools among major Medicare Advantage insurers, according to a February report from Corporate Insight shared with Becker’s. The report evaluated tools available on iOS and looked at…
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The Medicare Payment Advisory Commission estimated Medicare Advantage payments will be 14% greater than fee-for-service Medicare in 2026, according to a March 12 report from the congressional agency. That 14% equates to an extra $76 billion for MA, with the…
Aetna has agreed to pay $117.7 million to resolve allegations that it violated the False Claims Act by submitting or failing to withdraw inaccurate diagnosis codes for its Medicare Advantage enrollees in order to increase payments from CMS. The settlement…
Elevance said it was “surprised and disappointed” by a recent CMS sanction threat, which would suspend enrollment in Medicare Advantage prescription drug plans, CFO Mark Kaye said March 10 at the Barclays 28th Annual Global Healthcare Conference in Miami. The…
The Office of the Inspector General for HHS found 121,454 emergency department procedures were possibly billed incorrectly in 2021 and 2022, leading to over $15.1 million in improper or potentially improper payments. Medicare improperly paid physicians $922,524 and may have…
The Congressional Joint Economic Committee identified an additional $13.4 billion contributing to higher Medicare Part B premiums in 2025 due to Medicare Advantage overpayments, according to a March 10 report. The committee relied on Medicare Payment Advisory Commission estimates. Overpayments…