News

Medicare Advantage crisis deepens as Dr. Oz launches ‘aggressive’ audits
The plan to investigate the private health-insurance companies that run Medicare Advantage has been drastically expanded.
Healthcare Dive10d
CMS expands audits to crack down on Medicare Advantage overpayments
The agency said it would increase the number of MA plan audits and complete its backlog of reviews by investing in technology ...
Modern Healthcare10d
CMS to crack down on Medicare Advantage overpayment
The Centers for Medicare and Medicaid Services will audit every Medicare Advantage plan, every year to root out improper ...
Home Health Care News3d
CMS To Intensify Medicare Advantage Audits, Could Trigger ‘Untenable’ Home Health Rate Cuts
The Centers for Medicare & Medicaid Services (CMS) announced that it is ramping up audits of all Medicare Advantage (MA) plans – which could possibly ...
JD Supra5d
CMS to Immediately Begin Auditing Medicare Advantage Plans in Significant Expansion of Enforcement Efforts
On May 21, 2025, the Centers for Medicare and Medicaid Services (“CMS”) announced a significant expansion of its auditing ...
US Will Expand Its Audits of Medicare Advantage Health Plans
The Trump administration plans to expand government audits of private Medicare health plans, adding more scrutiny to an ...
Fierce Healthcare10d
CMS deploying more coders, 'advanced systems' to audit all Medicare Advantage contracts
The Centers for Medicare & Medicaid Services (CMS) will expand its team of medical coders and increase the number of audits ...
Humana and Other Health Insurer Stocks Fall as US Vows to Step Up Medicare Advantage Audits
Key Takeaways Shares of Humana and other health insurers fell Thursday after the Centers for Medicare & Medicaid Services ...
STAT10d
Trump, building on Biden policy, to speed up audits of Medicare Advantage insurers
CMS will hire nearly 2,000 coders to conduct audits to confirm diagnoses used for payment are backed by medical records.
JD Supra4d
CMS Announces Significant Changes to RADV Auditing Efforts: Considerations and Next Steps for the Medicare Advantage Industry
On May 21, 2025, the Centers for Medicare and Medicaid Services (“CMS”) announced plans to substantially increase both the pace and the scale of ...
American Hospital Association1d
GAO says CMS should target behavioral health services in prior authorization audits
The Government Accountability Office May 29 released a report recommending the Centers for Medicare & Medicaid Services ...
STAT5d
Hospitals earn big profits, insurers face ramped up Medicare Advantage audits
Last week, I was flipping through the newly filed financial documents of AdventHealth, and the numbers hit me like an ...