An appeals court has reversed a 2018 decision overturning Medicare's overpayment rule that required insurers to refund reimbursement to CMS within 60 days if they learn a diagnosis lacks medical record support.| Healthcare Dive
Volatility in MA stars for the 2023 plan year is raising questions around the earnings outlooks issued by payers.| Healthcare Dive
UnitedHealth, CVS, Elevance and peers sidestepped the worst of medical cost growth in the quarter, but many payers face uncertainty from Medicare Advantage star ratings, GLP-1s and other pressures.| Healthcare Dive
Both hospital and payer groups came out in support of the rule finalized Wednesday, finding common ground in the need to streamline prior authorization.| Healthcare Dive
2023-07-17-Update 2/2/24: We have updated our estimate for MA overpayments due to new research into coding intensity and favorable selection from| Committee for a Responsible Federal Budget