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March 16, 2017

Recent Stories

From Medicare Advantage News - The American Health Care Act, introduced March 6 by House Republicans, would have many implications for managed care organizations, including those that would have served an estimated 14 million people that stand to be without Medicaid coverage by 2026 due to the proposed defunding of Medicaid expansion starting in 2020. Read more

As CMS continues to promote the shift away from volume-based to value-based… Read more

At a recent congressional briefing at which various Medicare Advantage industry leaders… Read more

As Medicare Advantage organizations take a closer look at the 2018 Advance… 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.

March 22, 2017
Bonus Insight Reports for Subscribers

Several special reports covering key issues of concern to today’s health care executives are now available in your Subscriber Library. These original reports from the AIS Health editorial team are filled with practical strategies for managing Medicare patients’ pharmacy and medical costs. Access them at https://aishealth.com/newsletters/medicareadvantagenews/bonus-insight-re....

February 17, 2017
Justice Dept. Joins Whistleblower Lawsuit Alleging MA Upcoding by UnitedHealth Group, Affiliates

Justice Dept. joins whistleblower lawsuit alleging MA upcoding by UnitedHealth Group and affiliates. http://tinyurl.com/zuoymyn

February 1, 2017
2018 Advance Notice Includes Average Payment Hike of 2.75% for MA Plans

CMS on Feb. 1 released the 2018 Advance Notice and draft Call Letter for Medicare Advantage and Part D plans, approximately two weeks earlier than usual as per a new statutory requirement. Key payment changes highlighted by CMS officials during a press conference held the same day included an overall estimated payment increase of 0.25% for MA plans, which translates to an average payment hike of 2.75% when taking into account an estimated 2.5% coding trend, and the continuation of the 25%/75% blend of encounter data and RAPS data in calculating risk adjustment scores for 2018. View the notice here.

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