The Centers for Medicare and Medicaid Services is freezing enrollment in Elevance Health’s Medicare Advantage-Prescription Drug Plans for alleged noncompliance with risk adjustment and data submission ...

CMS suspend enrollment into Elevance Medicare Advantage plans starting March 31 due to noncompliance with risk adjustment data requirements.

The main difference between MedPAC and CMS estimates of uncorrected coding intensity is that MedPAC’s estimate accounts for the upward trend in coding intensity.

While provider and payer groups were happy that the Biden administration delayed implementation of changes to Medicare Advantage’s (MA's) risk adjustment model, they hinted at a sustained campaign to ...

As a result of insurers “upcoding” patient diagnoses, the Centers for Medicare and Medicaid Services (CMS) overpaid Medicare Advantage (MA) by $50 billion (or 13 percent) in 2024, according to the ...

Vice President JD Vance and CMS Administrator Mehmet Oz, MD, announced a series of actions affecting Medicare and Medicaid, including a $259.5 million deferral of federal Medicaid funding in Minnesota ...

For this audit, we reviewed one MA organization, Cigna-HealthSpring Life & Health Insurance Company, Inc. (Cigna), and focused on nine groups of high-risk diagnosis codes. Our objective was to ...

By Sriparna Roy March 2 (Reuters) - The Centers for Medicare & Medicaid Services intends to impose sanctions that would ...

"This conduct violates multiple statutory and regulatory requirements, including the obligation to submit accurate risk adjustment data through the required electronic systems, report and return ...