Medicare & Medicaid
Payments to insurance agents incentivize them to base referrals on financial considerations, DOJ says.
This is an 8% decline following the expiration of pandemic-era policies that temporarily increased star ratings for some plans.
Walgreens allegedly billed the government for prescriptions never dispensed, says DOJ.
After the acquisition closes, IU Health Plans will operate as part of Anthem Blue Cross and Blue Shield in Indiana.
The analysis also finds a high prevalence of vertical integration of PBMs with health insurance companies.
Files containing protected health information, such as Medicare claims data were compromised in a cyberattack involving MOVEit.
CMS has directed that over $4 million in monetary relief be paid to consumers or providers.
The growth poses challenges to providers' credit quality, given growing risks to reimbursement from MA plans.
Satisfaction among Medicare Advantage customers is 87 points higher than among customers of commercial member plans.
The CMMI model includes downsize risk and accounts for holistic care, such as mental and behavioral health, and health equity.