Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
1203 signals
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Better Information, Better Care: How Coding Supports Today’s Complex Patients
Correctly assessing the clinical status of a patient is imperative to delivering high-quality care. Patients today are older and more clinically complex, and new artificial intelligence tools are helping providers appropriately capture their patients’ conditions to aid in care planning.A report recently released by the Blue Cross Blue Shield Association suggests that hospitals’ use of AI-enabled documentation tools is driving higher healthcare costs through increased coding intensity. Its ana...
Blue CrossBlue ShieldBlue Cross Blue Shield plans · 36 signals · last 30 days -
Medicare Part D: Payments and Contracts Between Pharmacies and Plan Sponsors That Are Vertically Integrated
What GAO Found The insurance plan sponsors that provide Medicare Part D drug coverage have increasingly become vertically integrated—that is, under common ownership—with pharmacy benefit managers and pharmacies. GAO found that, for four large Part D plan sponsors, the pharmacies they owned accounted for about 24 percent of the Part D drugs they provided to their enrollees (drug utilization) and about 28 percent of the total payments to pharmacies in 2023 (see figure). Payments included both r...
Policy / Regulatory Changes · 140 signals · last 30 days -
Agency Information Collection Activities: Proposed Collection; 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 60 days for public comment on the proposed action. Int...
Policy / Regulatory Changes · 140 signals · last 30 days -
Trump announces $90 payments for seniors’ Medicare premium costs ahead of midterm elections
President Trump is promising more payments to voters just ahead of the Nov. 3 midterm elections — this time for seniors' Medicare Part B premiums
Financial / Operating Pressure · 31 signals · last 30 days -
Medicare Improvement Fund Premium Rebate Frequently Asked Questions
Medicare Improvement Fund Premium Rebate Frequently Asked Questions Q: What will the Medicare Improvement Fund do for Medicare beneficiaries? A: The Administration is making a $90 Premium Rebate available for Part B premiums to certain Medicare beneficiaries because the best way to improve Medicare is to put healthcare dollars back where they belong – in the hands of our Medicare beneficiaries – and make coverage more affordable.
Financial / Operating Pressure · 31 signals · last 30 days -
CMS Convenes Certified Independent Dispute Resolution Entity Leaders to Discuss Ways to Improve the Federal Program
CMS Convenes Certified Independent Dispute Resolution Entity Leaders to Discuss Ways to Improve the Federal Program
Policy / Regulatory Changes · 140 signals · last 30 days -
Medicare Advantage prescription drug plan options decline for 3rd year in a row: KFF
Medicare Advantage plan choices are shrinking modestly, with the number of MA prescription drug plan options for an average beneficiary dropping for the third year in a row, according to an Oct. 1 KFF analysis of CMS data. The average beneficiary has 28 MA-PD plan choices available for general enrollment in 2027, down from 32 […] The post Medicare Advantage prescription drug plan options decline for 3rd year in a row: KFF appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 140 signals · last 30 days -
‘This is an agent doing this’: Health insurers deploy AI to make your next medical appointment
Booking an appointment with a provider often means confirming they’re in network, working through an automated phone menu and trading available times with a receptionist. But for some UnitedHealthcare and Aetna members, an AI agent is now handling that work. Senior executives at both insurers have described their scheduling tools publicly in recent months as […] The post ‘This is an agent doing this’: Health insurers deploy AI to make your next medical appointment appeared first on Becker's P...
UnitedHealthcareAetnaUnitedHealthcare + CVS Health / Aetna · 60 signals · last 30 days -
Sens. King, Curtis Named ACHP’s 2026 Legislative Champions
Sens. Angus King and John Curtis named ACHP's 2026 Legislative Champions for protecting Medicare Advantage Star Ratings quality incentives. Source
Policy / Regulatory Changes · 140 signals · last 30 days -
HRSA names 10 drugmakers for revised 340B rebate pilot ahead of 2027 launch
The list of approved participants and drugs is larger than the controversial pilot's first attempted launch. It comes the same day that CMS launched a soon-to-be-mandatory data repository for Part D 340B claim submissions.
Policy / Regulatory Changes · 140 signals · last 30 days -
How Optum, Owensboro Health teamed up to build a virtual nursing program
Owensboro Health is teaming up with Optum Insight to pair bedside nurses with virtual nurses to free up frontline clinicians to dedicate more time to patient care.
OptumUnitedHealthcare · 47 signals · last 30 days -
Trump Administration Announces $7.2 Million to Expand Ambulance-Based Telemedicine and Upgrade Emergency Communications Across South Dakota
Trump Administration Announces $7.2 Million to Expand Ambulance-Based Telemedicine and Upgrade Emergency Communications Across South Dakota This federal investment will help South Dakota's rural ambulance crews reach patients faster, share critical health data with hospitals, and respond to emergencies with modern technology
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Aetna, Horizon BCBS join New Jersey working group to tackle state health benefits affordability
New Jersey Democratic Gov. Mikie Sherrill launched the State Health Benefits Program Reform Working Group on Oct. 1 to review and advise on health coverage for public employees. Ms. Sherrill announced the working group following a Sept. 2 agreement with 17 state employee unions. Along with unions, participants include public employer organizations, legislative offices and […] The post Aetna, Horizon BCBS join New Jersey working group to tackle state health benefits affordability appeared firs...
CVS Health / Aetna + Blue Cross Blue Shield plans · 48 signals · last 30 days -
Clover data breach affects more than 138,000
A Clover Health July data breach affected 138,677 people, according to a notice filed with HHS’ Office for Civil Rights. Clover flagged the incident to the Securities and Exchange Commission on July 17 after first learning of unauthorized activity on July 4. The Office for Civil Rights listed the Clover incident as a HIPAA case […] The post Clover data breach affects more than 138,000 appeared first on Becker's Payer Issues | Payer News .
Clover HealthClover Health · 2 signals · last 30 days -
Optum awarded $30B VA dental contract
The Department of Veterans Affairs has awarded Optum Serve a 10-year contract worth up to $30 billion to build and administer its national dental network. The network is set to be fully in place within a year of the award and will cover general and specialty dental care, preventive services and pharmacy support, according to […] The post Optum awarded $30B VA dental contract appeared first on Becker's Payer Issues | Payer News .
OptumUnitedHealthcare · 47 signals · last 30 days -
Devoted Health closes $1.2B financing deal amid expansion push
Medicare Advantage insurer Devoted Health has closed a $555 million Series G round as part of a $1.18 billion financing deal. The remainder is a $622 million commitment from the same investors to buy shares from existing Devoted shareholders through a tender offer, which is expected to close later in the fourth quarter, according to […] The post Devoted Health closes $1.2B financing deal amid expansion push appeared first on Becker's Payer Issues | Payer News .
Devoted HealthDevoted Health · 2 signals · last 30 days -
Aetna to acquire health plan from Ascension, CommonSpirit
San Francisco-based Dignity Health, part of Chicago-based CommonSpirit, reached an agreement to transfer its share of co-owned Arizona managed care health plan, Mercy Care, to CVS Health subsidiary Aetna. CommonSpirit had a 49.75% ownership interest in Mercy Care as of June 30, 2026, and June 30, 2025, according to CommonSpirit’s fiscal year 2026 report. Dignity […] The post Aetna to acquire health plan from Ascension, CommonSpirit appeared first on Becker's Payer Issues | Payer News .
CVS Health / Aetna · 14 signals · last 30 days -
AHA comments to MedPAC on differences in post-acute care use between MA, fee-for-service Medicare beneficiaries
The AHA provided comments to the Medicare Payment Advisory Commission Oct. 2 on a discussion from the commission’s September meeting on its examination of differences in post-acute care use between beneficiaries enrolled in Medicare Advantage and fee-for-service Medicare. The AHA said MedPAC’s preliminary findings reinforced concerns the AHA repeatedly shared with the commission, Congress and federal agencies. MedPAC found that MA beneficiaries used less post-acute care overall than FFS benef...
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SCAN, Costco roll out Medicare Advantage plans in California, Nevada
SCAN Health Plan and Costco shared Oct. 1 that their co-branded Medicare Advantage plans will go live in California and Nevada in 2027. The HMO will be available in 17 California counties and two Nevada counties on Jan. 1, a SCAN news release said. This is Costco’s first time offering MA. “Entering Medicare Advantage is […] The post SCAN, Costco roll out Medicare Advantage plans in California, Nevada appeared first on Becker's Payer Issues | Payer News .
SCAN Health Plan · 13 signals · last 30 days -
Many Medicare Part D Stand-Alone Drug Plan Enrollees Will See Modest Premium Increases for 2027, But Others Could Pay Much More If They Don’t Switch Plans
This brief analyzes the Medicare Part D stand-alone prescription drug plan (PDP) market for 2027. The analysis shows that there will be a modest reduction in the number of PDPs for 2027, along with modest premium increases less than $10 per month for many enrollees, but much larger monthly premium increases of $50 or more for others if they don’t change plans.
Policy / Regulatory Changes · 140 signals · last 30 days -
SCAN unveils 2027 MA slate, including launch of co-branded Costco plans
SCAN Health Plan has unveiled its product offerings for the 2027 plan year, and the slate includes the first launch in its partnership with Costco.
SCANSCAN Health Plan · 13 signals · last 30 days -
Independence Blue Cross to pay $22.5M to resolve MA fraud allegations
Independence Blue Cross will pay to settle allegations it defrauded Medicare by inflating diagnosis codes for MA beneficiaries. The payer cited “industry-wide challenges” in applying MA risk adjustment standards.
Blue CrossBlue Cross Blue Shield plans · 36 signals · last 30 days -
Global Benchmark for Efficient Drug Pricing (GLOBE) Model
This final rule implements the Global Benchmark for Efficient Drug Pricing Model (GLOBE Model), a new mandatory Medicare payment model under section 1115A of the Social Security Act. The GLOBE Model will test whether a payment model that uses an alternative method for calculating Medicare Part B drug inflation rebate amounts for certain separately payable Medicare Part B drugs and biological products reduces costs for Original Medicare (OM) beneficiaries and the Medicare program while preserv...
Policy / Regulatory Changes · 140 signals · last 30 days -
Legacy, UnitedHealthcare reach new contract, affecting tens of thousands of Oregonians
Legacy, UnitedHealthcare reach new contract, affecting tens of thousands of Oregonians The new contract was announced just hours before the old one was due to expire Joanne Zuhl Thu, 10/01/2026 - 14:20 Legacy Health has reached a new deal with the insurance giant UnitedHealthcare, ensuring continued in-network coverage for tens of thousands of Oregonians. Under the contract, all services provided by Legacy’s hospitals, clinics and providers will be covered for the insurer’s members at in-netw...
UnitedHealthcareUnitedHealthcare · 47 signals · last 30 days -
STAT+: Medicare Advantage plans shift more costs onto seniors in 2027
Premiums are stable, but Medicare Advantage plans are making big changes that could make care more expensive for patients.
Financial / Operating Pressure · 31 signals · last 30 days