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Complaints about gaps in Medicare Advantage networks are common. Federal enforcement is rare.
Government documents show that federal regulators rarely warn plans that their networks of health providers are so skimpy ...
In late 2024, the Centers for Medicare and Medicaid Services previewed a significant revision to the risk-adjustment model ...
Medicare Advantage insurers fully or partially denied 7.4% of prior authorization requests in 2022, an increase compared to the previous three years, according to an analysis by health policy research ...
Open enrollment for Medicare goes from Oct. 15 to Dec. 7 each year, when Medicare beneficiaries choose their coverage for the next plan year. As Medicare enrollees contemplate their choices for 2022, ...
A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars — only to abruptly back off amid an “uproar” ...
On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced [1] an aggressive plan (Plan) to expand its efforts to address fraud, waste, and abuse in Medicare Advantage (MA). By ...
With collaboration and evidence-based approaches, we can build a patient-centric health care system that works better for ...
MIAMI--(BUSINESS WIRE)--HealthSun Health Plans today announced that the Centers for Medicare & Medicaid Services (CMS) awarded its Medicare Advantage plans a 5-Star rating for the fifth year in a row, ...
Wellcare Medicare Advantage Plan in Florida Earns 4.5-Star Rating in Annual CMS Star Quality Ratings
FORT LAUDERDALE, Fla., Oct. 25, 2021 /PRNewswire/ -- Wellcare, a wholly owned subsidiary of Centene Corporation, announced today it received a 4.5-Star Rating (out of a possible five stars) from the ...
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