CMS Administrator Mehmet Oz, MD, discussed some of the biggest issues facing the Medicare Advantage program at an Oct. 15 industry conference. During his first six months on the job, CMS has already overseen policy moves to streamline prior authorization…
Medicare Advantage
Following the kickoff of Medicare open enrollment on Oct. 15, The Washington Post discovered inconsistencies in the Medicare Plan Finder, such as duplicative addresses and contradictory information regarding providers’ network status. After the Post reported the issues to CMS, an…
Alignment Health Plan and Intermountain Health have launched a Medicare Advantage plan together for older people in Nevada, according to an Oct. 14 news release. Alignment said the co-branded HMO received five stars for 2026 and will offer $0 premiums…
The Medicare open enrollment period runs from October 15 to December 7, setting insurers’ 2026 membership and revenue trajectories as beneficiaries select Medicare Advantage and Part D coverage. The 2026 cycle is unfolding amid a projected MA enrollment decline, lower…
CMS released its Medicare Advantage star ratings for 2026 on Oct. 9. Strong ratings, with five stars being the highest score, lead to plans earning quality bonus payments. Eighteen plans achieved a 5-star status, versus only seven last year. These…
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CMS shared its Medicare Advantage star ratings for 2026 on Oct. 9. Strong ratings lead to plans earning quality bonus payments, while plans that consistently underperform may encounter more oversight and a higher risk of contract cancellation. The number of…
CMS released Medicare Advantage star ratings on Oct. 9, showing an average score of 3.65 for 2026, compared to 3.92 last year. Plans were evaluated by the agency across 40 quality criteria spanning outcomes, experience, access, operations, and pharmacy. Plans…
The American Hospital Association critiqued the Medicare Payment Advisory Commission’s initial assessment of Medicare Advantage enrollment changes and its effect on hospital finances, according to an Oct. 3 letter from Molly Smith, AHA’s group vice president of public policy. MedPAC…
Sentara Health Plans will not offer Medicare Advantage, MA prescription drug HMO, or C-SNP plans in Virginia, North Carolina and Florida in 2026. “These products are no longer financially sustainable in the current environment. Industry-wide headwinds and market dynamics, including…
As many major insurers scale back on Medicare Advantage, some players are exiting the market entirely. Here’s a look at the insurers that are fully backing out: Editor’s note: This is not an exhaustive list. It will continue to be…