From Medicare Advantage News - The problems for Universal Health Care Group Inc. and its former executives deepened yet again when federal agents raided its St. Petersburg, Fla., headquarters March 28 as part of an apparent health care fraud investigation. The agents from the FBI and a federal task force, bearing search warrants but not disclosing what they were looking for, ushered all but a few employees out of the building and then removed files from storage cabinets and examined computers. Read more
From Medicare Advantage News - While it is hardly a major trend yet, and it may pale next to other new developments involving provider organizations, there is clear evidence that growing numbers of provider groups have decided within the past year that they want to buy or start Medicare Advantage plans. The new moves stem partly from the increasing desire of numerous provider organizations to assume risk so that they have the potential for greater financial… Read more
From Medicare Advantage News - CMS’s surprising proposal in the Feb. 15 “45-day notice” for Medicare Advantage plans’ 2014 payment rates to place strict limits on the use of health risk assessments (HRAs) for risk-adjustment purposes is getting mixed reviews from MA industry participants. Trade group America’s Health Insurance Plans (AHIP), in a March 1 letter to CMS, for instance, urged the agency to “reconsider” the proposal (MAN 2/28/13, p. Read more
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