Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
1195 signals
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CMS Proposes Reforms to Strengthen Transparency and Affordability in Medicare Advantage and Part D
CMS Proposes Reforms to Strengthen Transparency and Affordability in Medicare Advantage and Part D The Centers for Medicare & Medicaid Services (CMS) today issued a proposed rule that would improve the accuracy of provider directories for Medicare Advantage plans, establish transparency and compensation requirements for Pharmacy Benefit Managers (PBMs), and deliver enhanced cost-saving protections for low-income Medicare beneficiaries.
Policy / Regulatory Changes · 140 signals · last 30 days -
Medicare Program; Implementation of Sections 6219, 6220, and 6224 of the Consolidated Appropriations Act, 2026 (CMS-4214-P)
Medicare Program; Implementation of Sections 6219, 6220, and 6224 of the Consolidated Appropriations Act, 2026 (CMS-4214-P) Background
Policy / Regulatory Changes · 140 signals · last 30 days -
Trump Administration Announces More Than $11 Million to Strengthen Rural EMS and Expand Mobile Healthcare Across New Hampshire
Trump Administration Announces More Than $11 Million to Strengthen Rural EMS and Expand Mobile Healthcare Across New Hampshire This federal investment will create and expand mobile health programs, connect EMS agencies with rural hospitals, and bring more care directly to patients across New Hampshire
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Minnesota may need to claw back Medicaid funds from providers
The Minnesota Department of Human Services told Becker’s Oct. 15 that it may need to claw back funds from Medicaid providers if it faces a disallowance from CMS in the coming weeks. CMS has deferred $550 million in Medicaid funds to the state, according to an Oct. 2 letter from Minnesota DHS Temporary Commissioner John […] The post Minnesota may need to claw back Medicaid funds from providers appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 140 signals · last 30 days -
Closing the Post-Discharge and Readmission Gap:How Me+U Care Modernizes Member Communications for Health Plans
In today’s highly regulated landscape, health plans face increasing pressure to deliver timely, interactive outreach after a covered patient’s hospital discharge. Federal and state regulators require Medicare Advantage and Medicaid Managed Care Organizations to document every attempt and prove that outreach occurred within strict timelines. Medicare Advantage plans must complete outreach within two business days. […] The post Closing the Post-Discharge and Readmission Gap:How Me+U Care Modern...
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Fierce Healthcare Regulatory Recap: HHS presses medical groups on gender-affirming care for minors; CMS distributes RHTP funding to 5 states
The latest news from CMS and HHS this week: HHS demands info on ‘sex-rejecting procedures’ for minors, CMS releases more RHTP funds and more.
Policy / Regulatory Changes · 140 signals · last 30 days -
Trump Administration Announces New Funding to Expand Rural EMS and Bring More Care Directly to Patients Across Montana
Trump Administration Announces New Funding to Expand Rural EMS and Bring More Care Directly to Patients Across Montana This federal investment will give rural emergency medical teams the tools to provide in-home care, manage chronic conditions, and help Montanans avoid unnecessary emergency visits
Demographic Shifts · 3 signals · last 30 days -
CHOICE in Action: Ohio Employers Explore New Approach to Health Benefits
CHOICE in Action: Ohio Employers Explore New Approach to Health Benefits Federal leaders spotlight CHOICE Arrangement to aid Ohio small businesses in delivering flexible and affordable healthcare to workers
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Healthcare software company owner sentenced in $1B Medicare fraud scheme
The owner of healthcare software company HealthSplash was sentenced to 19 years in prison for his role in a scheme that prosecutors said fraudulently billed Medicare and other federal healthcare programs more than $1 billion for medically unnecessary equipment. Brett Blackman, 43, of Johnson County, Kan., was sentenced Oct. 14 after being convicted in April […] The post Healthcare software company owner sentenced in $1B Medicare fraud scheme appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 140 signals · last 30 days -
CMS opens petition period for 5 independent dispute resolution entities seeking recertification
The Centers for Medicare & Medicaid Services announced that the submission period opened Oct. 16 for petitions to deny the recertification of five independent dispute resolution entities. Members of the public, providers, facilities and others can submit a petition, which must identify the IDR entity seeking recertification and detail the reasons for the petition. The five organizations seeking recertification are Maximus Federal Services, Inc.; ProPeer Resources LLC; C2C Innovative Solutions...
Policy / Regulatory Changes · 140 signals · last 30 days -
CMS to exercise enforcement discretion regarding initial interdisciplinary team meeting requirement for IRF admissions
The Centers for Medicare & Medicaid Services announced that it will exercise enforcement discretion for inpatient rehabilitation facility admissions from Oct. 1, 2026 through March 31, 2027, with respect to the timing of the initial interdisciplinary team meeting requirement. As of Oct. 1, the initial IDT meeting must occur on or before four days from the date a patient is admitted to an IRF in order to implement appropriate treatment services; establish or review the patient’s stated rehabil...
Policy / Regulatory Changes · 140 signals · last 30 days -
CMS wants to quadruple provider suspensions in 6 months
A top CMS official wants provider suspensions to quadruple in the next six months as the agency puts new exclusion authority to work and tests AI tools to catch fraud, Nextgov/FCW reported Oct. 15. CMS Deputy Administrator Kimberly Brandt discussed the agency’s enforcement efforts Oct. 15 at the ADAPT conference in Santa Fe, N.M. Ms. […] The post CMS wants to quadruple provider suspensions in 6 months appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 140 signals · last 30 days -
Centene to expand CHOICE program to its Ohio, Oklahoma employees
Centene is expanding Custom Health Option and Individual Care Expense Arrangements, formerly known as individual coverage health reimbursement arrangements, to all of its Ohio and Oklahoma employees in plan year 2027. An Oct. 16 news release said the development builds on the company’s CHOICE rollout to Indiana-based employees in 2026. “Our experience in Indiana has […] The post Centene to expand CHOICE program to its Ohio, Oklahoma employees appeared first on Becker's Payer Issues | Payer Ne...
Centene · 13 signals · last 30 days -
Where Optum’s financials stand after rolling back ‘rapid expansion’
A year after executives said Optum Health had drifted from its original value-based care model, the smaller business is producing much larger profits, according to UnitedHealth Group’s Oct. 13 earnings release and call. Optum Health’s earnings from operations rose to $735 million in the third quarter, up from $41 million a year earlier. Its operating […] The post Where Optum’s financials stand after rolling back ‘rapid expansion’ appeared first on Becker's Payer Issues | Payer News .
UnitedHealthOptumUnitedHealthcare · 46 signals · last 30 days -
Agent, broker group sues CMS to block ACA registration freeze
The National Association of Benefits and Insurance Professionals filed a lawsuit against CMS and HHS on Oct. 15 concerning a temporary freeze on new agent and broker registrations with federally facilitated exchanges for 2027. CMS instituted the freeze under an interim final rule in September, which immediately went into effect and could run until Feb. […] The post Agent, broker group sues CMS to block ACA registration freeze appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 140 signals · last 30 days -
Voice AI startup careCycle rolls out free plan comparison tool for Medicare beneficiaries
The tool is free to use, takes no payments from payers or commissions and does not sell or share personal information. It surfaces yearly cost estimates and shows nearby plans that keep a patient's doctors in-network.
Competitive / Operational Strategy · 36 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 -
NABIP sues CMS over moratorium on new ACA broker registrations
The National Association of Benefits and Insurance Professionals is suing the Trump administration over its moratorium on new brokers entering the Affordable Care Act marketplaces.
Policy / Regulatory Changes · 140 signals · last 30 days -
Blue Shield of California adds former Lyft CFO to board
Erin Brewer is joining Blue Shield of California’s board of directors. Ms. Brewer had served as CFO of Lyft since 2023, and she now serves the company in an advisory capacity. Previously, she held leadership roles at Charles Schwab, Atlassian, and McKesson Corp. An Oct. 15 news release said her experience across industries will contribute […] The post Blue Shield of California adds former Lyft CFO to board appeared first on Becker's Payer Issues | Payer News .
Blue Shield CaliforniaBlue Cross Blue Shield plans · 36 signals · last 30 days -
Catching up with Blue Shield of California CEO Mike Stuart one year in
In August 2025, Blue Shield of California named Mike Stuart as its CEO. Now, a year later, he's reflecting on months of work toward addressing affordability, member access and the patient journey.
Blue Shield CaliforniaBlue Cross Blue Shield plans · 36 signals · last 30 days -
CMS Announces Resources, Flexibilities to Assist with Public Health Emergency in Alabama and Florida
CMS Announces Resources, Flexibilities to Assist with Public Health Emergency in Alabama and Florida The Centers for Medicare & Medicaid Services (CMS) announced today additional resources and flexibility available in response to a Public Health Emergency (PHE) in Alabama, beginning Oct. 7, 2026, and Florida, beginning Oct. 6, 2026, respectively, due to emergency conditions resulting from Hurricane Isaias and continuing. CMS is working closely with both states and federal partners to put flex...
Policy / Regulatory Changes · 140 signals · last 30 days -
UnitedHealth Group appoints chief marketing officer
Rocky Novak is joining UnitedHealth Group as chief marketing officer, effective Oct. 29. According to an Oct. 15 statement shared with Becker’s, Mr. Novak will lead enterprise marketing strategy, deepen stakeholder engagement and manage brands across UnitedHealth. “Rocky will work with leaders and teams across UnitedHealth Group to strengthen how the company engages in the […] The post UnitedHealth Group appoints chief marketing officer appeared first on Becker's Payer Issues | Payer News .
UnitedHealthUnitedHealthcare · 46 signals · last 30 days -
The best Medicare Advantage companies for 2027: US News
Kaiser Permanente led the 2027 U.S. News & World Report ratings for the “best overall” Medicare Advantage companies. The ratings, published Oct. 14, are based on a five-point scale, assigning weights to more than 30 CMS quality measures. After calculating contract ratings, U.S. News determined enrollment-adjusted average ratings for carriers. U.S. News considered MA companies […] The post The best Medicare Advantage companies for 2027: US News appeared first on Becker's Payer Issues | Payer N...
KaiserKaiser Permanente · 4 signals · last 30 days -
Elevance Health Foundation launched a prize program for patient safety initiatives. Here's why
The Elevance Health Foundation has launched a new prize program aimed at supporting solutions aimed at improving patient safety, with the first crop of winners targeting challenges like health literacy, fall prevention and medication errors.
ElevanceElevance Health · 16 signals · last 30 days -
CMS News: Trump Administration Announces $78 Million for Rural Healthcare Workforce, Chronic Disease Prevention, and Facility Upgrades Across Texas
Trump Administration Announces $78 Million for Rural Healthcare Workforce, Chronic Disease Prevention, and Facility Upgrades Across Texas These investments will support the rural health workforce, modernize aging equipment, and advance chronic disease prevention to keep quality care within reach for rural Texans.
Policy / Regulatory Changes · 140 signals · last 30 days