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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Members of Congress and hospital and health system leaders today gathered for a briefing in Washington, D.C., to discuss how payment delays in Medicare…
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The Centers for Medicare & Medicaid Services May 28 issued a final rule making changes to the Increasing Organ Transplant Access Model beginning July 1.…
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Approximately 35 million Americans are enrolled in Medicare Advantage plans in 2026, and that number is expected to grow to about 45 million MA enrollees by…
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The AHA May 7 wrote to House and Senate lawmakers in support of the Medicare Advantage Improvement Act (H.R. 8375/S. 4384), bipartisan and bicameral…
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The AHA today submitted comments on the Centers for Medicare & Medicaid Services’ proposed revisions to Medicare Advantage and Part D reporting…
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The AHA today released its Health Care Plan Accountability Update, covering the latest developments in Medicare Advantage, legislation and…