Medicare Advantage

Independence Blue Cross has agreed to pay $22.5 million to resolve allegations that it used inaccurate diagnosis codes to inflate its Medicare Advantage payments, according to a Sept. 30 Justice Department news release. The government alleged the insurer violated the…

Many major health insurers are pulling back from some counties in 2027, while Singh Holdings, Blue Cross of Idaho and Devoted Health boosted their footprint. CMS released data Sept. 28 on the 2027 Medicare Advantage landscape, showing which counties insurers…

CMS released initial insights on the 2027 Medicare Advantage landscape Sept. 28, along with data breaking down plans. One wrinkle gaining attention: enrollment capacity limits. In April, CMS said insurers could include enrollment caps for specific plans in their 2027…

UnitedHealthcare’s Medicare Advantage business in Texas received an estimated $24.4 million in overpayments during 2020 and 2021 tied to diagnoses not supported by medical records, the HHS Office of Inspector General said in an audit report published Sept. 28. The…

In 2026, 4.6 million Medicare Advantage beneficiaries, or 16% of enrollees, experienced disruptions to their health plan, according to a recent brief from the Alliance of Community Health Plans and consulting firm HealthScape Advisors. Hospitals have been dropping MA plans,…

Plans are expecting Medicare Advantage enrollment of 34 million beneficiaries in 2027, or about 47.4% of all Medicare enrollees, according to a Sept. 28 CMS news release. This would be flat compared with the 2026 projection, but actual MA enrollment…

Medicare Advantage plan choice will fall in more than half of states in 2027, even as CMS projects lower average premiums and a nearly unchanged number of available plans nationwide. The decline follows widespread disruption in 2026, when as many…

SCAN Health Plan is expanding into Oregon through a partnership with The Springs Living, an independent-living, assisted-living and memory care provider for older adults. The expansion brings the Medicare Advantage insurer into Oregon’s Clackamas and Washington counties. SCAN and The…

Five Medicare Advantage plans scored a full five stars in this year’s health plan rankings from the National Committee for Quality Assurance, up from three in 2025. An additional 15 plans, including five more Kaiser health plans from around the…

For too long, Medicare Advantage has rewarded plans for becoming better at documenting how sick their members are. The next era should reward them for demonstrating how much healthier they make their members. Medicare Advantage is now the dominant alternative…