The government just changed how Medicare Advantage scores health plans, and the results are big money shifts. New rules cut the number of quality checks insurers face, adding about $18. 6 billion to their profits over the next ten years. These changes came faster and went further than experts guesse
A California psychiatrist now facing serious fraud charges once loved showing off his glamorous life online. At 66, Gladwin Gill and his wife Amelou were recently arrested in a major federal operation called “Never Say Die. ” Prosecutors say they tricked Medicare into paying $5. 2 million for hospic
A three‑story office plaza in Los Angeles is home to 89 licensed hospice agencies, a number that raises eyebrows among regulators. The building, known as Merabi Professional Medical Plaza, hosts a mix of businesses—from a salon to a realty firm—yet the bulk of its tenants are hospice providers. S
The insurance arm of CVS Health, Aetna, has agreed to pay $117. 7 million to settle federal claims that it misrepresented patient diagnoses on Medicare Advantage plans. The lawsuit alleged that from 2018 to 2023, Aetna filed false diagnosis codes for morbid obesity and other conditions. These
A small medical supply shop in Austin is at the center of a federal complaint that says it billed Medicare for unnecessary urinary catheters. Investigators say the company, linked to a Russian citizen living in Texas, is part of a scheme that moved millions of dollars overseas. The complaint n
People in the United States are really worried about health care costs. It's not just groceries or rent that's causing stress, but the price of staying healthy. A recent poll shows that this worry is so big, it might even change how people vote in the next election. The poll found that about three-
UnitedHealth Group recently shared its fourth-quarter earnings, showing a slight beat on earnings per share but missing revenue expectations. The company reported $2. 11 in adjusted earnings per share, just above the $2. 10 expected by analysts. However, revenue came in at $113. 2 billion, falling s
The Trump administration has announced a tiny increase in payments for Medicare Advantage plans next year. The average raise is less than 0. 1%, which is way lower than the 4% to 6% the industry was hoping for. This news comes with new rules that might limit how insurance companies use medical codes
The stock market is feeling the pinch after the Trump administration dropped a bombshell on health insurers. They proposed keeping Medicare Advantage rates almost unchanged for next year. This news sent shockwaves through the industry, with big names like Humana, CVS Health, and UnitedHealth Group s
Maryland is making big changes to how hospitals get paid. This shift is called the AHEAD model. It will start in 2028. The state will lose control over setting Medicare rates. Instead, the federal government will take over. Private insurers are not happy. They think this will make health care even
