Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...

CMS has proposed a smaller than expected increase in Medicare Advantage payment rates for the upcoming plan year. The ...

In the largest Medicare Advantage fraud settlement to date, Oakland, Calif.-based Kaiser Permanente agreed to pay $556 million to resolve allegations it violated the False Claims Act by submitting ...

The MarketWatch News Department was not involved in the creation of this content. Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with ...

LEWES, Del., April 22, 2025 (GLOBE NEWSWIRE) -- John Snow Labs, the AI for healthcare company, today announced its new end-to-end Hierarchical Condition Category (HCC) coding engine designed to help ...

Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with Penguin Ai's HCC Coding & Risk Adjustment Snowflake Native App PALO ALTO, Calif., Jan.

Medicare Advantage is the dominant Medicare delivery system, now covering 54% of all Medicare enrollees. With the increase in enrollment and federal spending, however, has come increased scrutiny from ...

BELLEVUE, Wash.--(BUSINESS WIRE)--Edifecs, Inc., a global health information technology solutions company, today announced its new product, Concurrent Risk Adjustment (CRA). CRA helps Managed Care ...

The proposed 2027 Medicare Advantage payment update suggests a minimal 0.09% increase, affecting insurer stock prices and financial outlooks. Proposed Medicare Advantage payment updates spark concern ...

United States, 7th Aug 2024 - In the realm of healthcare, precision is everything. The accuracy of Hierarchical Condition Category (HCC) risk scores plays a pivotal role in the financial health of ...

Kaiser Permanente (Kaiser) has agreed to pay $556 million to resolve False Claims Act litigation alleging improper Medicare Advantage risk-adjustment practices, according to the U.S. Department of ...