The Centers for Medicare & Medicaid Services March 30 announced that C2C Innovative Solutions will replace Maximus in reviewing and processing appeals of adverse organization determinations and reconsiderations made by Medicare Advantage plans as of May 1. Maximum will continue to process appeals requests received on or before April 30. CMS said there will be a short period when both Maximus and C2C are issuing decisions. Updates on procedures for submitting appeal case files and other communications will become available on C2C's website beginning April 1. 

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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…
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The Medicare Payment Advisory Commission June 15 released its June report to Congress that estimated the association between Medicare Advantage enrollment and…
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The Department of Health and Human Services Office of Inspector General June 11 released two reports on high rates of coverage denials by Medicare Advantage…
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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…