Medicare Advantage in the headlines: 7 recent updates – 6

Becker's Healthcare December 30, 2024
Rylee Wilson

An insurer reached a nearly $100 million settlement over allegations of overpayments, and CMS plans to sunset a value-based model over “unprecedented” costs.

Here are seven Medicare Advantage updates Becker’s has reported since Dec. 10:

1. UnitedHealth Group has optimized its ability to increase Medicare Advantage members’ sickness scores and corresponding government payments by directly employing thousands of physicians at Optum and integrating sophisticated software tools into clinical workflows, according to an investigation from The Wall Street Journal.
2. Independent Health will pay up to $98 million to settle allegations a now-defunct subsidiary knowingly submitted invalid diagnoses to boost Medicare Advantage payments.
3. New York City must pay for the cost of any plan it offers to its retired...

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