From Medicare Advantage News - The Indiana Dept. of Administration on June 10 unveiled its intent to award Medicaid managed care contracts to four out of the five insurers that responded to a request for proposals, rejecting a bid from UnitedHealthcare unit UnitedHealthcare Community Plan. One of several Republican-led states to expand their Medicaid programs last year under terms of the Affordable Care Act (MAN 2/12/15, p. 5), Indiana will transition care from three to four insurers effective Jan. 1, 2017. Read more
From Medicare Advantage News - In a highly critical report posted May 9, the Government Accountability Office (GAO) calls out CMS for underdelivering on its risk adjustment data validation (RADV) audits, which in theory should spur CMS to begin collecting overpayments based on extrapolated audit findings and comply with an Affordable Care Act (ACA) mandate to establish recovery audit contractors (RACs) for the Medicare Advantage program. Read more
From Medicare Advantage News - In the midst of earnings releases and conference calls held by publicly traded Medicare and Medicaid insurers in late April and early May, the Pennsylvania Dept. of Human Services disclosed earlier than anticipated that eight plans total, including three large insurers, had won contracts to serve the state’s mandatory Medicaid managed care program for up to five years. The big winners were incumbent UnitedHealth Group, which won across all five… Read more
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