Medicare & Medicaid
More than $6M in claims were allegedly submitted to Medicare for DME and genetic testing that were medically unnecessary.
2024 had the highest share of ACOs receiving performance payments and most savings for ACOs and Medicare.
"Providers don't want to see rebate models, period," says Attorney Jeff Davis.
The nursing home’s severe understaffing, a result of financial fraud, led to several patient deaths, the New York AG finds.
Monarez "is not aligned with the president’s agenda of Making America Healthy Again," says White House spokesperson.
MA pays 10% to 15% less than what the government pays in traditional Medicare, report says.
A Texas judge vacated a 2024 final rule that would have limited payment to third-party administrators who help MA marketers.
The court says it lacks the ability to ‘second-guess’ CMS’ data collection and scoring methodology.
Overall customer satisfaction with Medicare Advantage plans is 623 (on a 1,000-point scale), down 29 points from a year ago.
There are almost no indicators that healthcare utilization is increasing more than 1% year-over-year, says analytics expert.