Elevance Health is suing CMS over its 2026 Medicare Advantage star ratings, arguing the agency gave competitor Clover Health a favorable recalculation after losing a court case to the insurer in May. In its July 1 complaint filed in the…
Medicare Advantage
The share of Medicare Advantage enrollees in plans that qualified for federal quality bonus payments dropped to 68% in 2026, its lowest point since 2018, according to a KFF analysis published July 1. Five things to know: 1. The drop…
UnitedHealth Group received the largest total Medicare Advantage bonus payments in 2026, pulling in $3.9 billion as total program spending reached $13.4 billion across all MA plans, according to a KFF analysis published July 1. The $13.4 billion in quality…
New Bern, N.C.-based CarolinaEast Medical Center has officially exited Blue Cross Blue Shield of North Carolina’s Medicare Advantage network while extending its participation in UnitedHealthcare’s Medicare Advantage plans through the end of the year. According to a updated payer list…
Longevity Health has earned a 5-star Medicare Advantage rating for its New Jersey Institutional Special Needs Plan, giving the payer its third 5-star contract following CMS’s recalculation of 2026 star ratings. Longevity’s I-SNP plans in Illinois and North Carolina also…
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CMS is rolling out the Medicare GLP-1 Bridge program — a demonstration designed to give eligible Medicare Part D beneficiaries access to certain GLP-1s at a fixed monthly cost — July 1. CMS officials, including CMS Administrator Mehmet Oz, MD,…
Centene executives are hoping to unlock healthy food as a Medicare Advantage benefit more broadly. In a May 11 Health Affairs article, Centene leaders and a University of California, San Francisco, professor made the case for CMS to expand access…
One federal lawsuit has set off a chain reaction in the Medicare Advantage world, reshaping star ratings and quality bonus payments — and which plans come out on top. Typically, on the one-to-five star-rating scale, four stars is the threshold…
Walgreens will begin supporting eligible Medicare beneficiaries through the new Medicare GLP-1 Bridge program at about 8,000 pharmacies when the initiative launches July 1. More than 56 million patients in the Medicare network may be eligible for the program, according to a June 25…
Earlier in June, the HHS Office of Inspector General published two reports shedding light on post-acute care denials and overturned appeals from Medicare Advantage organizations. AHIP is pushing back. “The reports ignore serious, well-documented concerns about wide variations in the…