Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
737 signals
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How Medicare Advantage Rebates Disadvantage Medicare’s Stand-Alone Drug Plan Market
The private plans that offer the Medicare Part D benefit - stand-alone drug plans and Medicare Advantage drug plans - are increasingly are competing on uneven terms, in part because the payment system for Medicare Advantage plans enables them to lower Part D premiums or reduce Part D cost sharing, making drug coverage from Medicare Advantage plans appear considerably cheaper, or even premium-free, to the beneficiary. This brief discusses the growing instability of the Part D stand-alone drug...
Policy / Regulatory Changes · 71 signals · last 30 days -
United States ex rel. Osinek v. Kaiser Permanente et al.
Medicare Advantage risk adjustment coding litigation. This case has been consolidated with five other lawsuits filed by former employees against Kaiser Permanente. The other five cases are: United States ex rel. Stein et al. v. Kaiser Foundation Health Plan, Inc. et al. (3:16-cv-05337); United States ex rel. Arefi et al. v. Kaiser Foundation Health Plan, Inc. et al. (3:16-cv-01558); United States […] The post United States ex rel. Osinek v. Kaiser Permanente et al. appeared first on Health Ca...
KaiserKaiser Permanente · 5 signals · last 30 days -
GoHealth, Inc.
Case 26-10914-TMH Doc 4 Filed 06/07/26 Page 1 of 41 IN THE UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF DELAWARE ) In re: ) Chapter 11 ) GOHEALTH, INC., et al.,1 ) Original document
GoHealth Delaware -
Medicare Advantage in 2026: Enrollment Update and Key Trends
More than half (55%) of eligible Medicare beneficiaries are enrolled in Medicare Advantage in 2026. To better understand trends in the growth of the Medicare Advantage program, this brief provides current information about enrollment, including by plan type and firm
Membership Movement · 5 signals · last 30 days -
Medicare Advantage in 2026: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization
This brief provides information about Medicare Advantage plans in 2026, including premiums, out-of-pocket limits, supplemental benefits, and prior authorization, as well as trends over time.
Financial / Operating Pressure · 13 signals · last 30 days -
AETNA NETWORK SERVICES LLC v. POONIA
Case 2:26-cv-06623-ES-MAH Document 1-17 Filed 06/05/26 Page 1 of 74 PageID: 139 EXHIBIT Q Case 2:26-cv-06623-ES-MAH Document 1-17 Filed 06/05/26 Page 2 of 74 PageID: 140 Provider manual Resources, policies and procedures at your fingertips Aetna.com 1126773-01-02 (8/23) Case 2:26-cv-06623-ES-MAH Document Original document
AetnaCVS Health / Aetna · 10 signals · last 30 days -
The Persistent Obamacare Enrollment Fraud
The post The Persistent Obamacare Enrollment Fraud appeared first on Paragon Health Institute .
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United States ex rel. Nezda v. American Imaging Management Inc. et al.
Medicare Advantage coverage denial litigation. The post United States ex rel. Nezda v. American Imaging Management Inc. et al. appeared first on Health Care Litigation Tracker .
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United States et al. ex rel. SW Challenger LLC. et al. v. Evicore Healthcare MSI LLC
Medicare Advantage coverage denial litigation. The post United States et al. ex rel. SW Challenger LLC. et al. v. Evicore Healthcare MSI LLC appeared first on Health Care Litigation Tracker .
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Medicare Advantage Out-of-Pocket Limits: Variation and Trends
This brief analyzes out-of-pocket limits in Medicare Advantage plans in 2026, variation by plan type, the distribution of enrollees facing different out-of-pocket limits, and trends over time.
Brokerage / Distribution · 1 signal · last 30 days -
IN RE: GENERIC PHARMACEUTICALS PRICING ANTITRUST LITIGATION
Case 2:16-md-02724-CMR Document 4469 Filed 05/21/26 Page 1 of 27 IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA IN RE: GENERIC PHARMACEUTICALS MDL 2724 PRICING ANTITRUST LITIGATION 16-MD-2724 THIS DOCUMENT RELATES TO: HON. CYNTHIA M. RUFE Humana Inc. v. Actavis Elizabeth, LLC, et al. 2:18-cv-03299 Original document
Humana PennsylvaniaHumana · 13 signals · last 30 days -
Medicaid Changes in House and Senate Reconciliation Bills Would Increase Costs for 1.3 Million Low-Income Medicare Beneficiaries
On May 22, the House passed a reconciliation bill, the One Big Beautiful Bill Act, which would partially pay to extend expiring tax cuts by cutting Medicaid. The Congressional Budget Office (CBO) estimates that the bill would reduce federal Medicaid spending by $793 billion over ten years and 10.3 million fewer people would be enrolled in Medicaid in 2034, including 1.3 million people with Medicare, otherwise known as “dual-eligible individuals”.
Demographic Shifts · 1 signal · last 30 days -
What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge
This brief describes current coverage of GLP-1s in Medicare and Medicaid, the Centers for Medicare & Medicaid Services’ (CMS) efforts to expand access and lower costs for GLP-1s through temporary demonstration programs including the BALANCE Model, and potential impacts on beneficiaries and program budgets.
Policy / Regulatory Changes · 71 signals · last 30 days -
Health Care Fraud Dashboard
The post Health Care Fraud Dashboard appeared first on Paragon Health Institute .
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Medicaid Waste, Fraud, and Abuse: Why CMS’s Improper Payment Rate Can’t Be Trusted
The post Medicaid Waste, Fraud, and Abuse: Why CMS’s Improper Payment Rate Can’t Be Trusted appeared first on Paragon Health Institute .
Policy / Regulatory Changes · 71 signals · last 30 days -
In Medicaid fraud crackdown, feds now looking to audit all 50 states
Dr. Mehmet Oz, the administrator of the federal Centers for Medicare & Medicaid Services, said Tuesday that the Trump administration will require every state within 30 days to turn in a plan to revalidate the health care providers that participate in their Medicaid programs. The Trump administration has pledged to root out what it calls […]
Policy / Regulatory Changes · 71 signals · last 30 days -
United States et al. ex rel. Mazik v. Kaiser Foundation Health Plan Inc. et al.
Medicare Advantage risk adjustment coding litigation. The post United States et al. ex rel. Mazik v. Kaiser Foundation Health Plan Inc. et al. appeared first on Health Care Litigation Tracker .
KaiserKaiser Permanente · 5 signals · last 30 days -
Better Medicare Alliance Statement on CY2027 Medicare Advantage and Part D Final Rate Announcement
WASHINGTON — Better Medicare Alliance (BMA) issued the following statement today from Mary Beth Donahue, President and CEO of Better Medicare Alliance, on the 2027 Medicare Advantage and Part D … Continue reading "Better Medicare Alliance Statement on CY2027 Medicare Advantage and Part D Final Rate Announcement" The post Better Medicare Alliance Statement on CY2027 Medicare Advantage and Part D Final Rate Announcement appeared first on Better Medicare Alliance .
Policy / Regulatory Changes · 71 signals · last 30 days -
United States v. Anthem Inc.
Medicare Advantage risk adjustment coding litigation. The post United States v. Anthem Inc. appeared first on Health Care Litigation Tracker .
AnthemElevance Health · 13 signals · last 30 days -
United States ex rel. Cutler v. Cigna Corporation et al.
Medicare Advantage risk adjustment coding litigation. The post United States ex rel. Cutler v. Cigna Corporation et al. appeared first on Health Care Litigation Tracker .
CignaCigna · 10 signals · last 30 days -
United States ex rel. Zafirov v. Florida Medical Associates, LLC et al.
Medicare Advantage risk adjustment coding litigation. The post United States ex rel. Zafirov v. Florida Medical Associates, LLC et al. appeared first on Health Care Litigation Tracker .
Policy / Regulatory Changes · 71 signals · last 30 days -
United States ex rel. Ormsby v. Sutter Health et al.
Medicare Advantage risk adjustment coding litigation. The post United States ex rel. Ormsby v. Sutter Health et al. appeared first on Health Care Litigation Tracker .
Policy / Regulatory Changes · 71 signals · last 30 days -
Limiting Medicaid Waste, Fraud, and Abuse: A Checklist for States to Protect Medicaid for the Vulnerable and the Taxpayers Who Finance It
The post Limiting Medicaid Waste, Fraud, and Abuse: A Checklist for States to Protect Medicaid for the Vulnerable and the Taxpayers Who Finance It appeared first on Paragon Health Institute .
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Re: CMS Request for Information (RFI) Related to Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) RIN 0938-AV97
The post Re: CMS Request for Information (RFI) Related to Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) RIN 0938-AV97 appeared first on Paragon Health Institute .
Policy / Regulatory Changes · 71 signals · last 30 days -
Bipartisan Majority of Voters Say Proposed Medicare Advantage Payment Rate Is Inadequate and Seniors Will Pay the Price
WASHINGTON — Voters across party lines say seniors will face higher costs and reduced benefits if Medicare Advantage funding doesn’t keep pace with rising medical costs — and warn it … Continue reading "Bipartisan Majority of Voters Say Proposed Medicare Advantage Payment Rate Is Inadequate and Seniors Will Pay the Price" The post Bipartisan Majority of Voters Say Proposed Medicare Advantage Payment Rate Is Inadequate and Seniors Will Pay the Price appeared first on Better Medicare Alliance .
Financial / Operating Pressure · 13 signals · last 30 days