Senators praised a recent CMS proposal aimed at reducing payments in MA, but urged the agency to work with Congress and go ...

Differential coding by Medicare Advantage plans appeared to have pushed their risk scores higher than traditional Medicare's scores. Those greater risk scores led to $33 billion in extra revenue for ...

CMS’s proposed changes to the MA program have a strong basis in the empirical evidence and would reduce excess spending in MA ...

Medicare Advantage could see major payment and oversight changes. Learn how the proposal may affect plan costs, coverage, and ...

Responding to criticisms lodged against an otherwise popular program among seniors, Senators Bill Cassidy, M.D. (R-LA) and Jeff Merkley (D-OR) introduced a bill to improve the way Medicare Advantage ...

Here's how overpayments to Medicare Advantage plans are driving up Part B costs for every Medicare beneficiary.

The Centers for Medicare and Medicaid Services has finalized risk adjustment policies in a final rule to prevent overpayments to Medicare Advantage Organizations. Studies and audits done separately by ...

SAN FRANCISCO, Jan. 14, 2026 /PRNewswire/ -- Kaiser Permanente (Kaiser) has agreed to pay $556 million to resolve False Claims Act litigation alleging improper Medicare Advantage risk-adjustment ...

Conclusions: Our findings suggest that Medicare inpatient encounters are associated with higher coding intensity than ...

The growth of the Medicare Advantage (MA) program to over half of eligible Medicare beneficiaries has made MA payment a salient part of Medicare policy discussions. Those discussions often focus on ...

Reintroducing Alzheimer disease and related dementias (ADRD) hierarchical condition categories (HCCs) into the Medicare Advantage (MA) risk-adjusted payment model was linked to improved care access ...