Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
96 signals
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Hospital groups rail against CMS' proposed 340B changes, site-neutral payments
Public comments for the latest OPPS proposed rule saw several major hospital groups all but threatening a court showdown over CMS' planned policy changes.
Policy / Regulatory Changes · 14 signals · last 30 days -
Oncology company Thyme Care raises $125M, backed by Morgan Health, Humana and CVS Health Ventures
Thyme Care landed a series E financing round of more than $125 million backed by strategic payers and providers as it aims to expand beyond cancer care navigation.
HumanaCVS HealthHumana + CVS Health / Aetna · 1 signal · last 30 days -
Scan.com raises $220M to expand US medical imaging network
The company plans to use the funding to further expand its U.S. network of imaging providers, as well as invest in its API and agentic AI infrastructure.
SCANSCAN Health Plan · 2 signals · last 30 days -
OIG: Medicare Part D plans spent millions on ineligible OTC drugs
Medicare Part D plans made millions in payments for drugs that were ineligible under the program, according to a new federal audit.
Policy / Regulatory Changes · 14 signals · last 30 days -
Trump Administration Announces $3.15 Million to Expand Pharmacy Connectivity Throughout Rural Ohio Communities
Trump Administration Announces $3.15 Million to Expand Pharmacy Connectivity Throughout Rural Ohio Communities This federal investment will improve interoperability and management of patient healthcare coordination
Competitive / Operational Strategy · 7 signals · last 30 days -
CMS Prevents $1.6 Billion in Fraudulent Medicare Laboratory Payments
CMS Prevents $1.6 Billion in Fraudulent Medicare Laboratory Payments 157 fraudulent lab providers revoked from Medicare program Centers for Medicare & Medicaid Services (CMS) enforcement actions have stopped more than $1.6 billion in potentially improper Medicare laboratory payments since the start of the Trump Administration – further evidence that CMS’ efforts to crush fraud are working to protect taxpayer dollars and improve Medicare program integrity. This includes $732 million in savings...
Policy / Regulatory Changes · 14 signals · last 30 days -
Trump Administration Announces $58 million to Deliver New Ambulances and Upgrade Emergency Communications Systems Across Hawaii
Trump Administration Announces $58 million to Deliver New Ambulances and Upgrade Emergency Communications Systems Across Hawaii This federal investment will help expand access, strengthen the health workforce, improve infrastructure, and advance technology for rural communities across Hawaii
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Trump Administration Announces $76 Million to Strengthen Regional Coordination and Modernize Healthcare Technology for New York
Trump Administration Announces $76 Million to Strengthen Regional Coordination and Modernize Healthcare Technology for New York This federal investment will strengthen regional partnerships, improve coordination of care, and expand access to healthcare services for rural New Yorkers
Competitive / Operational Strategy · 7 signals · last 30 days -
Trump Administration Announces $5.48 Million to Strengthen Healthcare Workforce Pipeline in Rural Rhode Island
Trump Administration Announces $5.48 Million to Strengthen Healthcare Workforce Pipeline in Rural Rhode Island This federal investment will expand career and technical education in Rhode Island to help train the next generation of healthcare professionals
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Trump Administration Invests $25 Million to Modernize Healthcare Technology, Expand Telehealth, and Improve High-Speed Internet Connectivity Across Michigan
Trump Administration Invests $25 Million to Modernize Healthcare Technology, Expand Telehealth, and Improve High-Speed Internet Connectivity Across Michigan This federal investment will help expand access and upgrade technology so doctors and patients can better connect and coordinate care across Michigan
Competitive / Operational Strategy · 7 signals · last 30 days -
A tale of 2 retailers: What drives success for co-branded Medicare Advantage plans
In August, SCAN Health Plan announced a partnership with Costco Wholesale Corp. to sell insurance products for older adults. Sound familiar? Costco is not the first retailer to partner with a Medicare Advantage insurer. Kroger has worked with Select Health and Priority Health on co-branded MA plans in 2023 and 2024. Websites outlining Select Health […] The post A tale of 2 retailers: What drives success for co-branded Medicare Advantage plans appeared first on Becker's Payer Issues | Payer Ne...
SCANSCAN Health Plan · 2 signals · last 30 days -
STAT+: Top Boston hospitals clash over Medicare Advantage network after split
First, Mass General Brigham split with Dana-Farber. Now its Medicare Advantage plan is dropping the cancer hospital.
Competitive / Operational Strategy · 7 signals · last 30 days -
8 recent Medicare Advantage contract suspensions, terminations
CMS has taken a series of enforcement actions against Medicare Advantage plans over the last two years, suspending enrollment and terminating contracts over issues ranging from network adequacy to financial solvency failures. Eight updates: The post 8 recent Medicare Advantage contract suspensions, terminations appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 14 signals · last 30 days -
Medicare paid estimated $380M for unused organs: OIG
Over a six-year period, Medicare may have spent $380 million on organs that were not ultimately used in covered enrollee transplants, according to a September HHS Office of Inspector General report. Under federal law, Medicare can only reimburse certified transplant centers for organs used in covered transplants. However, CMS guidance relies on the assumption that […] The post Medicare paid estimated $380M for unused organs: OIG appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 14 signals · last 30 days -
Democrats in talks about expanding Medicare, breaking up large insurers: Report
House Democrats are discussing a healthcare policy agenda that could include an expansion of the Medicare program, the Washington Post reported Sept. 3. House Minority Leader Hakeem Jeffries told NBC News that reversing the Medicaid cuts under H.R.1 and reviving enhanced ACA premium tax credits have “uniform Democratic support” ahead of the midterms. But privately, […] The post Democrats in talks about expanding Medicare, breaking up large insurers: Report appeared first on Becker's Payer Iss...
Financial / Operating Pressure · 2 signals · last 30 days -
CMS rebrands ICHRA
CMS has rebranded individual coverage health reimbursement arrangements to CHOICE Arrangements, or Custom Health Option and Individual Care Expense. The new name for the alternative health insurance model was announced Sept. 3 by CMS Administrator Mehmet Oz, MD, at an event in Indiana. ICHRAs let employers give workers a fixed, tax-free amount to buy their […] The post CMS rebrands ICHRA appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 14 signals · last 30 days -
CareFirst BCBS files trademark infringement complaint
CareFirst BlueCross BlueShield filed a trademark infringement lawsuit against a Hagerstown, Md.-based in-home healthcare and staffing company Aug. 27. The complaint, filed in the U.S. District Court for Maryland, said the insurer has more than 25 registrations issued by the U.S. Patent and Trademark Office for its “CAREFIRST” mark. The filing said the insurer has […] The post CareFirst BCBS files trademark infringement complaint appeared first on Becker's Payer Issues | Payer News .
BCBS MarylandBlue Cross Blue Shield plans · 3 signals · last 30 days -
Medicare Advantage Spending Comparisons Miss Key Costs and Benefits for Seniors, New Analysis Finds
BMA analysis identifies gaps in MedPAC methodology as Commission convenes September meeting WASHINGTON —As the Medicare Payment Advisory Commission (MedPAC) convenes its September meeting, Better Medicare Alliance today released a … Continue reading "Medicare Advantage Spending Comparisons Miss Key Costs and Benefits for Seniors, New Analysis Finds" The post Medicare Advantage Spending Comparisons Miss Key Costs and Benefits for Seniors, New Analysis Finds appeared first on Better Medicare Al...
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Medicare spent hundreds of millions of dollars on ineligible drugs, audit finds
Shoddy CMS oversight is to blame, and the agency needs to do better, the HHS Office of the Inspector General said. The CMS concurred.
Policy / Regulatory Changes · 14 signals · last 30 days -
UnitedHealthcare cuts prior authorization from 1,700 codes
The list tells providers what treatments will no longer need preapproval this October, part of UnitedHealthcare’s pledge to cull 30% of its much-maligned utilization management controls. The codes span a broad range of services.
UnitedHealthcareUnitedHealthcare · 2 signals · last 30 days -
Agency Information Collection Activities: Submission for OMB Review; Comment Request
The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, and to allow a second opportunity for public comment on the notice....
Policy / Regulatory Changes · 14 signals · last 30 days -
Louisiana’s Medicaid program will lose another provider, affecting 290,000 people
The Healthy Blue plan, offered by Elevance Health and Blue Cross Blue Shield of Louisiana, will no longer be available to Medicaid recipients in 2027.
Elevance Health + Blue Cross Blue Shield plans · 3 signals · last 30 days -
CHI St. Vincent no longer part of Blue Cross Blue Shield of Arkansas network
CHI St. Vincent will not be part of the Blue Cross Blue Shield of Arkansas network after the Little Rock-based hospital system and the insurer failed to reach an agreement on renewing their contract, both sides announced Tuesday. The two failed to reach an agreement during negotiations over the past several months about how much […]
Blue Cross Blue Shield plans · 3 signals · last 30 days -
Head of UnitedHealthcare’s Illinois market to oversee Wisconsin, Michigan
The head of UnitedHealthcare’s Illinois plan will now oversee Wisconsin and Michigan.
UnitedHealthcare · 2 signals · last 30 days -
PUBLIC COMMENT — Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems, etc, CMS-1850-P, RIN 0938-AV83
The post PUBLIC COMMENT — Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems, etc, CMS-1850-P, RIN 0938-AV83 appeared first on Paragon Health Institute .
Policy / Regulatory Changes · 14 signals · last 30 days