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Modern Healthcare3d
AI health risk assessments aim to boost Medicare Advantage pay
Automated health risk assessments powered by artificial intelligence are the latest tool to maximize Medicare Advantage ...
‘They don’t even read it’: This woman’s had heaps of insurance claims denied — now she uses AI for appeals
TNM says it reached out to Cigna, Humana and UnitedHealth Group for comment. UnitedHealth stated that “claims that we use an ...
Modern Healthcare2d
Downside risk, upside payment highlight new CMS innovation agenda
CMMI is planning a deeper foray into Medicare Advantage models ... Oz has promoted AI as a tool CMS and the healthcare system should more widely adopt, which is reflected in the CMMI plan.
JD Supra5d
CMS’s 2026 Final Medicare Advantage Rule Focuses on Implementing the IRA and Deregulation
Medicare Advantage and Part D Final Rule (Final Rule). With CMS releasing the 2026 Medicare Advantage and Part D Proposed ...
Healthy Returns: Trump provides a glimpse of the third round of Medicare drug price negotiations
The Trump administration is already gearing up for another round of Medicare drug price negotiations, while OpenAI launched a ...
Democrats push GOP toward Medicare ‘upcoding’ instead of Medicaid cuts
Democratic lawmakers are asking GOP leadership to reject Medicaid cuts in favor of going after Medicare Advantage “upcoding” ...