UnitedHealth faces structural margin compression, wage inflation, and regulatory headwinds, eroding its historical defensive ...

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced significant changes in its risk adjustment data ...

On May 21, 2025, the Centers for Medicare and Medicaid Services (“CMS”) announced plans to substantially increase both the pace and the scale of ...

New rules ignite a surge in payer demand for data platforms that support RADV readiness, Stars forecasting, and member ...

Last week, I was flipping through the newly filed financial documents of AdventHealth, and the numbers hit me like an ...

CMS will hire nearly 2,000 coders to conduct audits to confirm diagnoses used for payment are backed by medical records.

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JP Morgan analyst Lisa Gill reiterated her optimistic view on UnitedHealth Group Inc. (NYSE:UNH) despite the recent issues, ...

The Centers for Medicare and Medicaid Services will audit every Medicare Advantage plan, every year to root out improper ...

The Centers for Medicare & Medicaid Services (CMS) announced that it is ramping up audits of all Medicare Advantage (MA) plans – which could possibly ...

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 ...