CMS Suspends Elevance From Medicare Advantage Plans, Cites Noncompliance
Starting March 31, Elevance Health no longer may enroll people in its Medicare Advantage plans after it failed to submit required data about members' health conditions over a seven-year period. The suspension will not affect the 1.9 million people already enrolled.
Stat:
CMS Halts Enrollment In Elevance’s Medicare Advantage Plans, Citing Years Of Misconduct
Elevance Health will no longer be able to enroll people into its Medicare Advantage plans starting March 31, according to a new, harshly worded suspension notice from the Centers for Medicare and Medicaid Services. CMS is imposing the punishment after Elevance failed to submit required information to federal regulators over a seven-year period, the government said. The suspension will not affect the 1.9 million people who were already enrolled in an Elevance Medicare Advantage plan heading into this year. (Herman, 3/2)
Modern Healthcare:
Medicare Advantage Insurers Back CMS Curb To Chart Review Payment
Medicare Advantage insurers may be willing to relinquish one moneymaking tactic if that means they can avoid taking a bigger hit down the line. The Centers for Medicare and Medicaid Services has proposed modifying the Medicare Advantage risk-adjustment system to exclude diagnoses insurers uncover in chart reviews but aren’t connected to medical claims. Insurers benefit financially when Medicare Advantage members are categorized as sicker and costlier to cover. (Tepper, 3/2)
CBS News:
Mount Sinai, Anthem Extend Deadline Before Thousands Of Patients Lose In-Network Care Due To Contract Dispute
As Mount Sinai Health System and Anthem Blue Cross Blue Shield negotiate a new contract, the parties agreed to temporarily extend their deadline before tens of thousands of patients in New York lose access to in-network care. About 9,000 Mount Sinai physicians became out-of-network to roughly 200,000 Anthem patients when the sides failed to reach an agreement on Dec. 31, but state law mandated no changes for patients before March 1. (DeAngelis, 3/2)
KFF Health News:
Even Patients Are Shocked By The Prices Their Insurers Will Pay — And It Costs All Of Us
Samantha Smith of Harrisburg, Pennsylvania, went into the operating room for emergency removal of an ectopic pregnancy. “I’m grateful I didn’t die,” she said, but she was shocked to see that the outpatient surgery was billed to her insurer for about $100,000. (Rosenthal, 3/3)
On health care personnel —
Modern Healthcare:
Former UVA Health CEO Dr. K. Craig Kent Files Defamation Lawsuit
Former UVA Health CEO Dr. K. Craig Kent filed a defamation lawsuit over the alleged circumstances of his resignation from the health system last year. Kent left UVA Health in February 2025 following an internal investigation spurred by a letter the health system’s physician group sent to the university board alleging that he neglected patient care concerns. Kent said he was open to feedback after physicians sent the initial letter, which more than 120 physician group faculty members signed anonymously. (Kacik, 3/2)
Bloomberg:
Oracle Health Cerner Loses Multiple Executives
Oracle Corp.’s health records division has lost multiple senior leaders in recent months while the company works to modernize its software in the face of steep customer loses. Executive Vice President Sanga Viswanathan and Senior Vice President Suhas Uliyar are leaving the firm, some workers were told last week, according to people who asked not to be identified because the departures hadn’t been announced. The two were among the most senior product and engineering leaders of that division. (Ford, 3/2)
MedPage Today:
Study Links Nurse Understaffing To Higher Risk Of Death, Readmissions
Understaffing of hospital nurses was linked to worse patient outcomes, especially during day shifts, according to a retrospective cohort study from Japan. Among more than 77,000 hospital admissions across 82 acute care hospital wards, patients exposed to nurse understaffing over a 24-hour period and during day shifts had a higher risk of in-hospital mortality versus those who experienced adequate staffing ... reported Noriko Morioka, PhD, of the National Institute of Public Health in Wako, and co-authors. (Firth, 3/2)
