Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...

In the largest Medicare Advantage fraud settlement to date, Oakland, Calif.-based Kaiser Permanente agreed to pay $556 million to resolve allegations it violated the False Claims Act by submitting ...

The Trump administration has released proposed payment rates in Medicare Advantage (MA) and Part D for the 2027 plan year, ...

CMS released its 2027 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies, proposing a net average year-over-year payment ...

Explore 2025 managed care enforcement trends under the Trump administration. Learn about Department of Justice (DOJ) and ...

The proposed 2027 Medicare Advantage payment update suggests a minimal 0.09% increase, affecting insurer stock prices and financial outlooks. Proposed Medicare Advantage payment updates spark concern ...

For healthcare executives, the proposed MA changes reinforce a growing disconnect between CMS policy goals and provider experience. Even as CMS seeks to rein in plan behavior, providers remain the ...

On a day when health insurers were reeling from the Trump administration proposing minimal increases to Medicare Advantage (MA) rates next year and a tightening of risk adjustment rules, a top CMS ...

A Senate report accuses UnitedHealth Group of turning Medicare Advantage risk adjustments into a profit strategy.

Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with Penguin Ai's HCC Coding & Risk Adjustment Snowflake Native App PALO ALTO, Calif., Jan.