A federal audit released this month found that Methodist Hospital received at least $12.4 million in Medicare overpayments over a two-year stretch of billing, and the Hospital has told investigators it does not owe most of that money. The finding comes from the U.S. Department of Health and Human Services Office of Inspector General, which…

Medicare’s annual enrollment window is approaching, and millions of households will soon start comparing plans for next year. One number they will not have in hand yet is the 2027 Part B premium, deductible or income-related monthly adjustment amounts, the figures that determine what enrollees actually pay each month starting in January. The Centers for…

UnitedHealthcare of Wisconsin, Inc., the company behind Medicare Advantage contract H5253, submitted diagnosis codes to the federal government that a new watchdog review says the medical records did not support. The Department of Health and Human Services’ Office of Inspector General checked a sample of enrollee cases and found most of the codes it tested…

Medicare beneficiaries managing heart failure or a lung condition such as chronic obstructive pulmonary disease are getting a new coverage option, but only if they are enrolled in Original Medicare. The Centers for Medicare & Medicaid Services confirmed on September 15, 2026, that it will widen an existing chronic-care program to cover four additional conditions…

A federal watchdog has concluded that HumanaChoice, a Medicare Advantage plan run by Humana, Inc. under contract H5216, collected government payments tied to diagnosis codes that patients’ own medical records did not back up. The finding comes from a compliance audit covering payment years 2020 and 2021, built on a sample of enrollee records that…

Medicare’s drug-price negotiation program entered a new phase on January 27, 2026, when the Centers for Medicare & Medicaid Services named 15 more high-cost prescriptions for its third round of price talks, plus one existing drug picked for the program’s first-ever renegotiation. In the first two rounds, every selected drug came out of Part D,…

Every fall, a handful of Medicare Advantage insurers decide not to bring a plan back for the following year, and federal law spells out exactly how much warning members are owed before that happens. The rule works on two clocks at once: a rolling 90-day minimum tied to the plan’s actual end date, and a…

Millions of Medicare Advantage enrollees carry a supplemental-benefit debit card loaded with an annual allowance for groceries, over-the-counter items or other extras. For years, that card only checked where it was swiped — a participating retailer’s terminal — not what actually landed in the cart. A federal rule finalized this spring closes that gap starting…

Several rules that had governed, since 2023, exactly when and how a licensed sales agent could pitch a Medicare Advantage or Part D plan to an older adult have now been stripped away. The changes sit inside the Centers for Medicare & Medicaid Services’ Contract Year 2027 Medicare Advantage and Part D final rule, finalized…

Federal regulators have quietly eliminated one of the only tools Medicare Advantage enrollees had for finding out, partway through the year, that a chunk of a plan’s dental, hearing or grocery allowance was about to go unused. Under a final rule the Centers for Medicare & Medicaid Services issued this spring, insurers will no longer…