News

Medicare Advantage crisis deepens as Dr. Oz launches 'aggressive' audits
The latest blow comes from Mehmet Oz, the physician and former TV personality turned MAGA Republican who now runs Medicare on behalf of the Trump administration. This week he announced a dramatically ...
Health Care Declines as Insurers Weigh - Health Care Roundup
Health-care companies declined as a rout in health-insurance shares continued because of increased government oversight of Medicare payments. UnitedHealth Group continued its retreat, while Humana ...
Amazon S3 on MSN1d
Health Care Stocks Like UnitedHealth, CVS Tank On Wednesday: Here's Why
Healthcare stocks plunged in after-hours trading Wednesday after the Centers for Medicare & Medicaid Services announced a ...
Healthcare Dive1d
CMS expands audits to crack down on Medicare Advantage overpayments
The agency said it would increase the number of MA plan audits and complete its backlog of reviews by investing in technology ...
Humana, UnitedHealth Stocks Fall. It’s All About a Medicare Crackdown.
Shares of big health insurer were in the red Thursday after the Centers for Medicare and Medicaid Services (CMS) said it ...
Modern Healthcare2d
CMS to crack down on Medicare Advantage overpayment
The Centers for Medicare and Medicaid Services will audit every Medicare Advantage plan, every year to root out improper ...
The Hill15d
Democrats push GOP toward Medicare ‘upcoding’ instead of Medicaid cuts
Democratic lawmakers are asking GOP leadership to reject Medicaid cuts in favor of going after Medicare Advantage “upcoding” as a way of saving federal dollars and addressing waste ...
STAT16d
Democrats urge Republicans to target Medicare Advantage ‘upcoding’ instead of cutting Medicaid
09. As Republicans in Congress debate ways to cut Medicaid so they can fund tax breaks, Democrats are pushing them in a different direction: cut excess spending in Medicare Advantage instead.
Healthline1mon
Dual Eligible Medicare Medicaid Income Limits
Dual eligibility usually depends on your age, any disabilities you might be living with, and your income. This article discusses the dual eligible Medicare and Medicaid income limits for 2025 and ...
JD Supra1mon
Skilled Nursing Facilities: CMS Extends Medicare Revalidation Deadline
On April 17, 2025, the Centers for Medicare and Medicaid Services (CMS) announced another extension of the deadline by which skilled nursing facilities (SNFs) must revalidate their Medicare ...
McKnight's Long-Term Care News1mon
Zeal to find overpayments may see CMS auditors put nursing homes in crosshairs
“Medicare enrollment revocations, Medicaid enrollment terminations, and extrapolated overpayments resulting from program integrity concerns can have devastating effects on providers,” attorney ...
Pharm Exec1mon
Making Real-World Evidence Work for Medicare: What CMS’ Draft Guidance Gets Right and What Needs Work
CMS’ draft guidance on real-world data study protocols marks a significant move toward transparency and rigor in Medicare coverage decisions. CMS’ draft guidance on study protocols using real-world ...