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. The report said that UHG appeared to leverage its size, vertical integration and data analytics to stay ahead of CMS’ efforts to counteract unnecessary spending related to coding practices. “After a review of the records, this report provides evidence that shows UHG has turned risk adjustment into a major profit centered strategy, which was not the original intent of the program,” the report said.

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The Centers for Medicare & Medicaid Services has released 2027 Medicare Advantage plan information, including star ratings, through the Medicare Plan…
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The AHA provided comments to the Medicare Payment Advisory Commission Oct. 2 on a discussion from the commission’s September meeting on its examination of…
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The Centers for Medicare & Medicaid Services announced Sept. 28 that it projects declines in average premiums for Medicare Advantage and Part D in 2027.…
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The U.S. District Court for the Eastern District of Pennsylvania Aug. 5 granted a motion for the AHA and the Hospital and Healthsystem Association of…
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The Centers for Medicare & Medicaid Services July 27 released its Contract Year 2025 Part C and Part D Program Audit and Enforcement Report, outlining key…
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Medicare Advantage now covers more than half of eligible Medicare beneficiaries, making its impact on hospitals, health systems and patients impossible to…