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Showing 1-20 of 1,617 results for "medicare advantage"

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Some Rural Hospitals Ditch Medicare Advantage

By Arielle Zionts April 11, 2025 KFF Health News Original

Get our weekly newsletter, The Week in Brief, featuring a roundup of our original coverage, Fridays at 2 p.m. ET.

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A digital illustration of an outstretched hand holding a gold coin with a dollar sign on it. The sleeve around the person's wrist had white stars on a blue background and red and white stripes.

The Medicare Advantage Influence Machine

By Fred Schulte and Holly K. Hacker September 30, 2024 KFF Health News Original

New court filings and lobbying reports reveal an industry drive to tamp down critics — and retain billions of dollars in overcharges.

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A green clipboard with a Medicare Part C form. A pen rests on top of the form.

Sick of Fighting Insurers, Hospitals Offer Their Own Medicare Advantage Plans

By Susan Jaffe January 26, 2026 KFF Health News Original

Breakups between insurers and health systems, on top of plan cuts, left more than 3.7 million Medicare Advantage enrollees facing a tough choice last year: find new insurance or new doctors. But hospital systems say their Advantage plans can avert such upheaval, giving patients peace of mind.

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A photo showing Mehmet Oz sitting at a table in a court room.

Las quejas sobre deficiencias en Medicare Advantage son comunes, pero la supervisión federal es rara

By Susan Jaffe November 21, 2025 KFF Health News Original

Documentos gubernamentales obtenidos por KFF Health News muestran que la agencia que supervisa Medicare Advantage no se esfuerza por hacer cumplir normas vigentes.

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A photo of the Kaiser Permanente logo on the facade of a building.

Kaiser Permanente To Pay $556 Million in Record Medicare Advantage Fraud Settlement

By Fred Schulte January 15, 2026 KFF Health News Original

Kaiser Permanente agrees to pay $556 million to settle allegations of billing the government for conditions patients didn’t have.

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A photo showing Mehmet Oz sitting at a table in a court room.

Complaints About Gaps in Medicare Advantage Networks Are Common. Federal Enforcement Is Rare.

By Susan Jaffe November 20, 2025 KFF Health News Original

Health systems drop out of Medicare Advantage plans all the time. Yet government documents obtained by KFF Health News show that federal regulators rarely warn plans that their networks of health providers are so skimpy they violate legal requirements.

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Medicare Advantage Insurers Face New Curbs on Overcharges in Trump Plan That Reins in Payments

By Fred Schulte January 29, 2026 KFF Health News Original

Proposed Trump administration changes to federal Medicare Advantage payments would stop health insurers from mining patient data for extra medical diagnoses that generate more bills to taxpayers even without treatment.

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A man in business attire, with short-cut greying hair, stands in front of a hospital building. With his hands on his hips, he smiles. Behind him, building signage reads: "Brookings Health System"

Rural Hospitals Question Whether They Can Afford Medicare Advantage Contracts

By Arielle Zionts April 8, 2025 KFF Health News Original

Some rural hospitals have canceled — or are considering ending — contracts with insurance companies that offer Medicare Advantage plans, saying the private policies jeopardize their finances and impede patient care.

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Trump’s DOJ Accuses Medicare Advantage Insurers of Paying ‘Kickbacks’ to Brokers

By Julie Appleby May 23, 2025 KFF Health News Original

Get our weekly newsletter, The Week in Brief, featuring a roundup of our original coverage, Fridays at 2 p.m. ET.

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A photo of an older man having his blood pressure checked by a doctor in an exam room.

Trump’s DOJ Accuses Medicare Advantage Insurers of Paying ‘Kickbacks’ for Primo Customers

By Julie Appleby May 19, 2025 KFF Health News Original

The Department of Justice alleges that several major health insurers paid brokerages “hundreds of millions of dollars in kickbacks” to get agents to steer consumers into their Medicare Advantage plans, allegations the insurers strongly dispute.

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A photo of a clipboard resting horizontally on a table with a piece of paper that reads, "Medicare Advantage." In front of it are an open pill bottle spilled yellow capsules, a stethoscope, and a pen.

When Hospitals Ditch Medicare Advantage Plans, Thousands of Members Get To Leave, Too

By Susan Jaffe April 28, 2025 KFF Health News Original

Breakups between health providers and Advantage plans are increasingly common. The Centers for Medicare & Medicaid Services has allowed whole groups of patients to leave their plans.

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Federal Watchdog Urges Crackdown on Medicare Advantage Home Visits

By Fred Schulte November 22, 2024 KFF Health News Original

Medicare officials are pushing back against a federal watchdog’s call to crack down on home visits by Medicare Advantage health plans — a practice the watchdog says may waste billions of tax dollars every year. In late October, a Health and Human Services inspector general audit found that the insurers pocketed $7.5 billion in 2023 from diagnosing health conditions that […]

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Watchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits

By Fred Schulte November 8, 2024 KFF Health News Original

Medicare officials defend the use of home visits that often spot medical conditions that are never treated.

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A green clipboard with a Medicare Part C form. A pen rests on top of the form.

Cansados de pelear con las aseguradoras, hospitales ofrecen sus propios planes Medicare Advantage

By Susan Jaffe January 26, 2026 KFF Health News Original

Aunque los planes administrados por hospitales representan solo una pequeña porción del mercado de Medicare Advantage, su número de afiliados sigue creciendo, en línea con el aumento general de beneficiarios de ese sistema.

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An older woman wearing glasses stands in her kitchen.

Blurry Line Between Medical and Vision Insurance Leaves Patient With Unexpected Bill

By Tony Leys January 30, 2026 KFF Health News Original

A Wisconsin retiree with glaucoma needed her eyes examined. Her Medicare Advantage plan from UnitedHealthcare listed her optometrist’s clinic as in-network, but she learned the hard way that a clinic can be in-network and out-of-network at the same time.

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A photo of a large corporate building with the United Healthcare logo on it.

UnitedHealth Wins Ruling Over $2B in Alleged Medicare Advantage Overpayments

By Fred Schulte March 4, 2025 KFF Health News Original

A special master found the Justice Department failed to prove wrongdoing by the giant health insurer.

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Private Medicare, Medicaid Plans Exaggerate In-Network Mental Health Options, Watchdogs Say

By Tony Leys October 20, 2025 KFF Health News Original

A federal probe of Medicare and Medicaid plans run by private insurance companies found that the plan operators often overstated how many mental health providers were available in their networks. In some cases, investigators found providers had never had contracts with plans they were listed on.

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KFF Health News Sues To Force Disclosure of Medicare Advantage Audit Records

By Fred Schulte November 12, 2024 KFF Health News Original

Freedom of Information Act case targets HHS inspector general’s reviews of billions of dollars in health plan overpayments.

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Election Outcome Could Bring Big Changes to Medicare

By Stephanie Armour Updated November 4, 2024 Originally Published November 4, 2024 KFF Health News Original

Democrats and conservatives are divided over whether the federal health program for people over 65 should be run almost entirely by the private sector. If Trump retakes the White House, the shift to Medicare Advantage may accelerate.

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Feds Killed Plan To Curb Medicare Advantage Overbilling After Industry Opposition

By Fred Schulte August 27, 2024 KFF Health News Original

A private 2014 decision by the Centers for Medicare & Medicaid Services faces new scrutiny in a multibillion-dollar Justice Department fraud case against UnitedHealth Group.

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