CMS' new Medicare Advantage auditing standards did not include enough information about auditing methods to understand its full impacts, Humana executives said on a Feb. 1 investor call.
Payer Policy Updates
CMS will implement stricter audits of Medicare Advantage plans, a move that could leave payers on the hook for billions of dollars in repayments to the federal government.
HHS is proposing a new pathway for no-cost contraceptive coverage for employees of organizations with religious objections to covering these services.
A proposed rule change coming from CMS is making payers nervous.
The nation's largest insurers are gearing up for upcoming changes to Medicare Advantage risk adjustment rules that could collectively cost them up to $3 billion in returned payments, with Humana potentially facing the biggest penalties, Bloomberg reported Jan. 24.
The Blue Cross Blue Shield Association has released a set of policy proposals it says will reduce U.S. healthcare costs by $767 billion over 10 years.
AHIP is focused on Medicaid redeterminations and promoting competition in the marketplace for 2023.
Over 700,000 providers and organizations are participating in one of CMS' three accountable-care programs in 2023, the agency said Jan. 17.
Though negotiated prices won't appear until 2026, CMS is starting to implement the first-ever negotiated prices for drugs paid for by Medicare.
HHS has extended the COVID-19 public health emergency until April 11.