The plan to investigate the private health-insurance companies that run Medicare Advantage has been drastically expanded.

Shares of Humana and other health insurers fell Thursday after the Centers for Medicare & Medicaid Services said it plans to ...

New rules ignite a surge in payer demand for data platforms that support RADV readiness, Stars forecasting, and member ...

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced significant changes in its risk adjustment data ...

The agency said it would increase the number of MA plan audits and complete its backlog of reviews by investing in technology ...

The Centers for Medicare and Medicaid Services will audit every Medicare Advantage plan, every year to root out improper ...

The Trump administration plans to expand government audits of private Medicare health plans, adding more scrutiny to an ...

The Centers for Medicare & Medicaid Services (CMS) will expand its team of medical coders and increase the number of audits ...

Medicare Advantage plans are based on an enrollee's diagnosis; those with more serious or chronic conditions receive higher ...

CMS will hire nearly 2,000 coders to conduct audits to confirm diagnoses used for payment are backed by medical records.

UnitedHealth Group Inc. investors had another bitter pill to swallow, along with those of other Medicare Advantage plan ...

The Centers for Medicare & Medicaid Services May 21 announced it will immediately begin annual audits of all Medicare ...