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CMS is recalculating some 2026 Medicare Advantage Star Ratings after a court ruled it improperly calculated Clover Health’s rating, a decision that could boost payments for a small...
Elevance Health is suing the feds over its recent recalculations for the 2026 Medicare Advantage star ratings.
Elevance filed a lawsuit last week against the Department of Health and Human Services and the Centers for Medicare & Medicaid Services, alleging that CMS unlawfully refused to...
A recent court ruling in favor of Clover Health is leading the feds to recalculate Medicare Advantage's star ratings for 2026, and analysts at Capstone warn that this "foreshadows...
Roughly 78% of VA medical centers earned four or five star ratings from the Centers for Medicare & Medicaid Services this year.
Sixteen US insurance carriers have earned Insurance Business America’s 5-Star Claims designation for 2026, as rated by brokers across the country on claims management, communicatio...
CMS established a new national framework setting performance thresholds to qualify noninvasive, biomarker-based colorectal cancer screening options — including FDA-approved stool-...
KFF estimates Medicare will spend $13.4 billion on the Medicare Advantage Quality Bonus Program in 2026 amid continued scrutiny of the program. The post Medicare to Spend $13B on M...
CMS awarded Serco a $109 million contract to review a randomized sample of claims for the agency’s Comprehensive Error Rate Testing program The seven-year contract will be performe...
CMS ACCESS Model launches in July: What doctors should know ...
CMS has launched the third RMADA contract vehicle with a $3.5 billion ceiling over five years Seventeen companies secured spots after a competition that drew 34 offers The contract...
Public comments submitted this week rule skewered a proposed 2.4% net rate increase as insufficient in light of substantial financial headwinds. An accompanying mandatory expansion...
The feds are set to pay out at least $13.4 billion in Medicare quality bonus payments this year, up slightly year-over-year and reflecting a rapid escalation in spending over the p...
The Centers for Medicare & Medicaid Services has added language ...
For years, seniors and doctors have complained that prior authorization delays can feel like a second illness layered on top of an existing medical problem....
Recognition signifies a formal commitment to continuous improvement in quality care
Brilliant Care's nurse-led, AI-enabled care model has demonstrated an average 21 mmHg reduction in systolic blood pressure and a 2.56 point reduction in HbA1c, providing a proven f...
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