Deputy Administrator Jon Blum signaled regulators could increasingly crack down on bad actors in the MA program, which now covers more than half of Medicare seniors.| Healthcare Dive
The figure is almost triple prior estimates, highlighting the need for payment reform to avoid overtaxing the Medicare system, researchers said.| Healthcare Dive
The agreement settles a whistleblower lawsuit against Cigna that the Department of Justice joined last year, and requires the payer to undergo annual auditing from an independent entity.| Healthcare Dive
Risk adjustment changes will now be phased in over three years, after payers pushed back on the proposed payment rule.| Healthcare Dive
The payer, which brings in the bulk of its revenue from Medicare, is fighting a rule finalized earlier this year to claw back overpayments in the increasingly popular MA program.| Healthcare Dive
The insurer said its employer segment no longer meets Humana’s long-term strategic plans.| Healthcare Dive
The CMS proposed a 0.2% dip in MA rates. However, analysts said regulators will likely improve the payment rate in the final notice.| 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
Despite heavy lobbying, insurers failed to see MA rates improve in the final rule, which codified a 0.16% decrease to benchmark funding.| Healthcare Dive