The U.S. Department of Justice has completed its 2025 National Health Care Fraud Takedown, which resulted in criminal charges against 324 defendants for their alleged participation in various healthcare fraud schemes involving more than $14.6 billion.
CenterWell, Humana’s senior-focused primary care division, will continue to expand throughout 2025, with plans to open centers in new metro areas, including Augusta and Savannah, Georgia; the Triad Region (Burlington, Greensboro and Winston Salem) in N…
Upward of 44 million people, or 16.4% of the non-elderly U.S. population, have been covered by an Affordable Care Act initiative, including health plan enrollment and Medicaid expansion, finds a new KFF report.
The Centers for Medicare and Medicaid Services is terminating the Medicare Advantage Value-Based Insurance Design (VBID) model at the end of 2025 due to what it called the model’s “substantial and unmitigable costs to the Medicare Trust Funds.”
The Medicare Shared Savings Program (MSSP) yielded more than $2.1 billion in net savings in 2023 – the largest savings in the program’s history, according to the Centers for Medicare and Medicaid Services.
Elevance Health President and CEO Gail Boudreaux said the insurer is “considering all of our options” regarding the Centers for Medicare and Medicaid Services’ 2025 Medicare Advantage Star Ratings, which saw the company take a hit in its star ratings.
If Medicare were to cover anti-obesity medications (AOMs), federal spending would increase about $35 million between 2026 and 2034, finds a new Congressional Budget Office report.
After increasing by more than 400% between 2015 and 2023, federal spending on Medicare Advantage bonus payments will decline by $1 billion to $11.8 billion in 2024 – an 8% decline – following the expiration of pandemic-era policies that temporarily inc…
The Medicare Advantage program recently achieved the milestone of covering more than half of all Medicare beneficiaries, but according to a report from S&P Global Ratings, this could have an adverse impact on hospital margins.
Even as the hospitals and health systems continue to battle with Medicare Advantage programs over reimbursement rates, customer satisfaction with MA plans is significantly higher than with commercial member health plans, according to the J.D. Power 202…
