Medicare Advantage
The House Ways and Means Subcommittees on Health and Oversight held a joint hearing today to discuss lessons learned, challenges and opportunities to improve the Medicare Advantage program.
Inappropriate denials for prior authorization and coverage of medically necessary services are a pervasive problem among certain plans in the Medicare Advantage (MA) program.
The AHA July 3 released the Health Care Plan Accountability Update for the second quarter of 2025.
The Departments of Justice and Health and Human Services today announced the creation of the DOJ-HHS False Claims Act Working Group to combat health care fraud.
A report released June 17 by NORC at the University of Chicago, commissioned by the Coalition to Strengthen America’s Healthcare, found that patients enrolled in Medicare Advantage plans are more likely to experience longer hospital stays and experience delays in transfer to post-acute care…
The Centers for Medicare and Medicaid Services May 30 released a notice requesting comments on a proposed Medicare Advantage service level data collection for initial determinations and appeals. The granular data will be used to enhance audit activities to ensure MA plans are operating in…
The Government Accountability Office May 29 released a report recommending the Centers for Medicare & Medicaid Services target behavioral health services when auditing Medicare Advantage plans’ use of prior authorization.
The Centers for Medicare & Medicaid Services May 21 announced it will immediately begin annual audits of all Medicare Advantage plans and work to clear a backlog of audits from 2018 through 2024.
AHA expresses support for Senate legislation, the Improving Seniors’ Timely Access to Care Act.
AHA expresses support House legislation, the Improving Seniors’ Timely Access to Care Act.