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Senate report says UHG used ‘aggressive strategies’ to increase MA payments
A Senate Judiciary Committee report released Jan. 12 found that UnitedHealth Group used “aggressive strategies” to maximize its Medicare Advantage risk-adjustment scores and collect higher payments from diagnoses of MA enrollees.
CMS issues RFI on effort to revamp Medicare claims system
The Centers for Medicare & Medicaid Services has released a request for information seeking input on replacing its Medicare claims processing system with a real-time, cloud-based platform.
AHA Comments on MedPAC Payment Update Recommendations
AHA respectfully requests that you consider the following issues before making your final payment update recommendations at the January Medicare Payment Advisory Commission (MedPAC) meeting.
AHA urges MedPAC to recommend higher payment updates ahead of January meeting
The AHA Jan. 9 urged the Medicare Payment Advisory Commission to consider, during its next meeting Jan. 15-16, higher payment updates for the inpatient and outpatient prospective payment systems than those discussed in December and to examine Medicare Advantage’s role in access to care and provider financial stability.
CMS releases form for submitting provider complaints on Medicare Advantage plans
The Centers for Medicare & Medicaid Services has implemented an online form for providers to submit complaints regarding Medicare Advantage plans.
Applications open for fifth round of Medicare-funded GME residency slots
The application period has opened for hospitals to apply for the latest allocation of Medicare-funded graduate medical education residency slots under Section 126 of the Consolidated Appropriations Act of 2021.
CMS announces pilot on MA service level data collection for initial determinations, appeals
The Centers for Medicare & Medicaid Services released a memo Dec. 16 announcing the agency’s intent to conduct a voluntary pilot in 2026, called the Service Level Data Collection for Initial Determinations and Appeals.
CMS releases 2025 Measures Under Consideration List
The Centers for Medicare & Medicaid Services Dec. 15 published the Measures Under Consideration List for 2025. These are measures that CMS is considering adopting through the federal rulemaking process for use in Medicare programs.
MedPAC issues draft payment recommendations for 2027
The Medicare Payment Advisory Commission Dec. 4 and 5 discussed draft payment update recommendations for 2027, which the commission will vote on in January.
CMS Issues Proposed Rule for CY 2027 Medicare Advantage, Prescription Drug Plans
The Centers for Medicare & Medicaid Services (CMS) Nov. 28 released its proposed Policy and Technical Changes to the Medicare Advantage (MA) Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program and Programs of All-Inclusive Care for the Elderly for Contract Year (CY) 2027.