The No UPCODE Act (No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act), introduced in 2025, proposes changes to Medicare Advantage (MA) risk adjustment under the guise of improving payment accuracy. However, these changes…
The No UPCODE Act (No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act), introduced in 2025, proposes changes to Medicare Advantage (MA) risk adjustment under the guise of improving payment accuracy. However, these changes…
Health assessments, also commonly known as health risk assessments, are an established component of the Medicare program. This fact sheet offers an overview of health assessments, how they’re utilized in Medicare Advantage, and they value…
A new report by Avalere examines the Centers for Medicare and Medicaid Services’ (CMS) Advance Notice of Methodological Changes for Calendar Year (CY) 2024 for Medicare Advantage Capitation Rates and Part C and Part D…