News

JD Supra3d
CMS to Immediately Begin Auditing Medicare Advantage Plans in Significant Expansion of Enforcement Efforts
On May 21, 2025, the Centers for Medicare and Medicaid Services (“CMS”) announced a significant expansion of its auditing ...
American Hospital Association8d
CMS to expand audits of MA plans
The Centers for Medicare & Medicaid Services May 21 announced it will immediately begin annual audits of all Medicare ...
Humana and Other Health Insurer Stocks Fall as US Vows to Step Up Medicare Advantage Audits
Key Takeaways Shares of Humana and other health insurers fell Thursday after the Centers for Medicare & Medicaid Services ...
CMS expands audit efforts for Medicare Advantage plans in the U.S.
The U.S. Centers for Medicare & Medicaid Services (CMS) announced a major expansion of its audit efforts for Medicare ...
Healthcare Dive8d
CMS expands audits to crack down on Medicare Advantage overpayments
The agency said it would increase the number of MA plan audits and complete its backlog of reviews by investing in technology ...
Home Health Care News2d
CMS To Intensify Medicare Advantage Audits, Could Trigger ‘Untenable’ Home Health Rate Cuts
The Centers for Medicare & Medicaid Services (CMS) announced that it is ramping up audits of all Medicare Advantage (MA) plans – which could possibly ...
JD Supra2d
CMS Announces Significant Changes to RADV Auditing Efforts: Considerations and Next Steps for the Medicare Advantage Industry
On May 21, 2025, the Centers for Medicare and Medicaid Services (“CMS”) announced plans to substantially increase both the pace and the scale of ...
UnitedHealth takes another gut punch from government, as CMS boosts audit team
UnitedHealth investors have another bitter pill to swallow, as the CMS said it was aggressively growing its audit team to ...
HME News8d
CMS accelerates MA audits
CMS plans to increase its team of medical coders from 40 to about 2,000 by Sept. 1 as part of a significant expansion of its ...
STAT9d
Trump, building on Biden policy, to speed up audits of Medicare Advantage insurers
CMS will hire nearly 2,000 coders to conduct audits to confirm diagnoses used for payment are backed by medical records.
US Will Expand Its Audits of Medicare Advantage Health Plans
The Trump administration plans to expand government audits of private Medicare health plans, adding more scrutiny to an ...
American Hospital Association13h
GAO says CMS should target behavioral health services in prior authorization audits
The Government Accountability Office May 29 released a report recommending the Centers for Medicare & Medicaid Services ...