Policy Updates

Medicare Advantage audits are "unequivocally not cuts" in funding, HHS says. 

Proposed changes to Medicare Advantage payments could cut benefits for members, according to a report commissioned by the Better Medicare Alliance. 

In January, CMS said it will implement stricter auditing practices around Medicare Advantage plans, but payers and policy experts say they have a lot of questions about the next steps forward.

President Joe Biden has vowed to strike down any law that cuts Medicare spending — but cutting spending can come in many forms.

AHIP, the trade association representing the insurance industry, is opposed to some of CMS' proposed changes to the Medicare Advantage star ratings program. 

Provider groups are applauding CMS' proposed rule overhauling prior authorization in Medicare Advantage. 

As the U.S. prepares to end the COVID-19 public health emergency, hospitals are facing a major cut in Medicare payments used to treat patients diagnosed with the disease.

New York state legislators and stakeholders are debating a bill that would overhaul the state's health system and establish a single-payer system, Spectrum News reported Feb. 9. 

Traditional Medicare and Medicare Advantage beneficiaries could begin seeing lower copays for certain Part B drugs beginning April 1, according to new guidance from HHS. 

Payer executives are expecting to lose members in their Medicaid managed care contracts as states begin the redetermination process, but some are hopeful to convert some of these members to other lines of business.