In the News

10% of Medicare Advantage enrollees forced to switch plans for 2026: Study OIG: Medicare Advantage Fraud Overview Health Exec: $50B MA Fraud Allegations Thomson Reuters: 2024 MA and Medicaid Fraud Investigations Fierce Healthcare: DOJ Targets MA Fraud JD Supra: OIG Special Fraud Alert OIG Featured Topics on Managed Care

WSJ: Extra Payments via Upcoding Brookings: MA Spending & Business Practices Cornell University: MA Costs More, Provides Less STAT News: UnitedHealth Algorithm Denies Care Journalist’s Resource: How STAT Investigated MA Algorithms NYT: Seniors, Algorithms & Care Denials Blumenthal: Insurers Denying Critical Care NYT (2022): MA Fraud Allegations AHA: Senate Report on MA Prior Authorization As Medicare Advantage Enrollment Grows, So Does Awareness of Problems CBS: State of Denial: How Insurance Companies Impact Health Care Today

AHA Report: Medicare Advantage is Devastating Rural Hospitals Medicare Advantage is Devastating Rural Hospitals

Hospitals, providers spent $25B on battles over claims, report finds 32 health systems dropping Medicare Advantage plans | 2024 Medicare Advantage Denies 17 Percent Of Initial Claims; Most Denials Are Reversed, But Provider Payouts Dip 7 Percent

How Many Physicians Have Opted Out of the Medicare Program? Skyrocketing Hospital Administrative Costs, Burdensome Commercial Insurer Policies Impacting Patient Care HFMA + Eliciting Insights CFO Survey

TN Medicare Data 2025 99% of doctors in Tennessee take Medicare - less than half accept any Medicare Advantage plan

Insurers’ Prior Authorization Data Offers Little Insight Into What Gets Approved or Denied The Medicare Advantage paradox: Who benefits most? KFF Health Tracking Poll: Prior Authorizations Rank as Public’s Biggest Burden When Getting Health Care Insurers Pocketed $50 Billion From Medicare for Diseases No Doctor Treated To cut ‘waste and fraud,’ reform Medicare Advantage