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May 19, 2016

Recent Stories

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

Far in advance of transitioning to its new pharmacy benefit manager (PBM)… Read more

CMS on April 25 issued a long-awaited Medicaid managed care rule, finalizing… Read more

While much of the attention stemming from last month’s release of the… Read more

From the Editor

Welcome to your Medicare Advantage News subscriber-only Web page

Be sure to visit often, for PDFs of issues, archives of articles, links to government documents and more!

Please e-mail me with your comments on the last issue of Medicare Advantage News, story ideas for future issues, or any other suggestions you have that can make the newsletter more useful for you.

May 24, 2016
Medi-Cal Mulls Restarting PBM Bid Process

As Magellan Rx fights for a PBM contract, Medi-Cal considers rejecting all pharmacy bids and starting over.

May 6, 2016
Triple-S Posts Q1 Earnings

Triple-S Management's net income dropped 62% YOY to $3.4 million, reflecting higher managed care MLR.

May 4, 2016
Humana Beats Q1 Projections, Reaffirms Guidance

Humana reported earnings of $1.86 per share, on track to maintain its full-year guidance.

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