Medicare Advantage

Jan 31, 2023
CMS finalized technical details regarding the Medicare Advantage Risk Adjustment Data Validation program, which the agency uses to recover improper risk adjustment payments from MA plans when the medical diagnoses submitted for payment are not supported in the beneficiary’s medical record.
Jan 14, 2023
AHA staff will summarize the key provisions of the Medicare Advantage proposed rules, provide an opportunity for Q&A, and solicit hospital and health system input into AHA commentary and advocacy.
Dec 15, 2022
The AHA commends CMS for taking important steps to increase oversight of Medicare Advantage plans to help ensure enrollees have equal access to medically necessary health care services that should be covered.
Dec 6, 2022
The Centers for Medicare & Medicaid Services tonight released a proposed rule that would require Medicare Advantage, Medicaid and federally-facilitated Marketplace health plans to streamline processes related to prior authorization.
Dec 2, 2022
As Congress convenes for its post-election lame-duck session, we are turning up the pressure to secure additional support for hospitals and the patients and communities they serve. We need to put on a full-court press — and that includes all of us reaching out to our senators and representatives —…
Nov 14, 2022
The AHA has urged congressional leaders to include a number of important provisions in a year-end legislative package to ensure that hospitals and health systems are able to continue their mission of caring for the communities they serve.