The CMS found Medicare Advantage plans' provider directories have widespread inaccuracies for the third year in a row, which could lead to fines for the insurers.
The HHS secretary on Tuesday expounded on the Trump administration's vision to overhaul Medicare financing.
Kentucky-based Medicaid managed-care health insurer Passport Health Plan has introduced a pilot program to address the high rate of premature births among its members by using analytics to identify at-risk patients earlier in their pregnancies.
The CMS wants to make a few dramatic changes to the way it audits Medicare Advantage plans for overpayments. That could leave insurers on the hook for billions of dollars.
National health insurer Anthem continued its streak of higher quarterly profit in the third quarter of 2018 as it grew Medicare Advantage membership, raised premiums to cover medical costs and spent less money on claims.
Home healthcare programs are proliferating as health plans and at-risk providers look for ways to keep patients out of the hospital or from returning after being discharged.
The CMS released a proposed rule Friday that would implement parts of the 2018 budget deal, including allowing Medicare Advantage plans to offer government-funded telehealth services to seniors starting in 2020.
The Trump administration is looking at new risk structures, including direct provider contracting, to drive cost-saving behaviors in the healthcare industry. But CMMI Director Adam Boehler said that won't dent the Medicare Advantage business.
Healthcare experts widely expected the Affordable Care Act to hobble Medicare Advantage. But Since 2010, enrollment in Medicare Advantage has doubled to more than 20 million enrollees, growing from a quarter of Medicare beneficiaries to more than a third.
UnitedHealth Group leads the pack into earnings season with its third-quarter results. In the second quarter, the company reported both higher revenue and profit.
Ahead of Medicare open enrollment, the CMS said seniors enrolled in traditional Medicare will pay slightly higher premiums and deductibles in 2019.
DaVita Medical Holdings paid the U.S. Justice Department $270 million to settle allegations that it used improper Medicare Advantage billing practices that led to inflated payments.