medicare advantage

Global markets wavered Tuesday as investors braced for President Trump's Iran deadline regarding the Strait of Hormuz. Fears of escalating Middle East conflict sent oil prices soaring and dragged down US stocks, particularly tech shares. Health insurers offered some support, but overall market sentiment remained cautious amid heightened geopolitical tensions and uncertainty.

In a shocking turn of events, Anar Rustamov, previously of the Bay Area, finds himself in the crosshairs of federal authorities for allegedly masterminding a breathtaking $90 million healthcare fraud. Prosecutors claim he submitted thousands of fraudulent invoices for medical devices that were never actually provided, all through a shell organization he established.

Cigna Group, a health insurer, has announced a resolution with the United States regarding allegations of overcharging the government's medicare advantage program. The settlement addresses concerns that Cigna misrepresented patients' health conditions to make them appear more severe than they actually were.

Insurance giant UnitedHealth Group is facing a criminal investigation by the US Justice Department for possible Medicare fraud, the Wall Street Journal reported Wednesday. The Wall Street Journal previously reported in February that UnitedHealth was under investigation over allegations it directed doctors to make patient diagnoses that would trigger high government payments under medicare advantage.

President-elect Donald Trump has nominated Dr. Mehmet Oz, a renowned television personality, to lead the Centers for Medicare and Medicaid Services. This unexpected appointment raises concerns due to Oz's lack of government experience and controversial medical stances. Oz will collaborate with Robert F. Kennedy Jr.

The assassination of UnitedHealthcare's CEO has sparked scrutiny of health insurance practices, particularly the "delay, deny, defend" allegations. The privatization of Medicaid and Medicare, along with rising prior authorization denials, are fueling the debate. The future of ACA subsidies remains uncertain, with potential coverage losses under a Trump administration.

UnitedHealth Group shares saw a big drop. The company lowered its 2025 earnings prediction. This was due to higher medical costs in its Medicare plans. Other health insurance companies like Elevance and CVS Health also experienced declines. Hospital companies like HCA Healthcare, however, saw gains. The health insurance sector faces increasing challenges.

The Centers for Medicare and Medicaid Services (CMS) is launching an AI-powered pilot program in six states by 2026 to assess the appropriateness of medical services for Original Medicare recipients. This initiative, known as the WISeR Model, aims to reduce wasteful and inappropriate care by using AI algorithms to expedite prior authorization processes.

An Indian-origin executive at a Florida-based provider of managed care services has agreed to pay US $7,50,000 to resolve his alleged role in an extensive fraud scheme perpetrated at the company.

US government officials said on Friday that key details of Trump's election-year giveaway still have to be fleshed out, including the exact timing and how Medicare's cost would be covered — a sum that could approach $7 billion. It's also unclear which Medicare enrollees will get the promised cards.

CMS directive highlights the need for transparency and accountability in AI and algorithmic usage in coverage determinations, responding to concerns raised by House of Representatives members regarding medicare advantage plans.

UnitedHealthcare CEO Brian Thompson was shot and killed outside a Manhattan hotel yesterday. Authorities suspect a targeted attack. Thompson, who earned over $10 million annually, led the company since 2021 and oversaw coverage for over 49 million Americans. The investigation is ongoing.

Babubhai Bhurabhai Rathod of Michigan had pleaded guilty to both charges in August 2018, US Attorney Andrew Birge said. US District Judge Janet Neff also ordered Rathod to pay over USD 939,000 in restitution to federal health insurance programmes Medicare and Medicaid.

Many Americans aim for early retirement around 63, but financial experts advise caution. Retiring too early can lead to reduced Social Security benefits, higher healthcare costs before Medicare, and the risk of outliving savings. Delaying retirement until 65-67 offers increased financial security through higher benefits and Medicare eligibility, ensuring a more stable and enjoyable post-work life.

UnitedHealth Group's CEO Andrew Witty resigned due to personal reasons amidst financial challenges, prompting Stephen Hemsley to return as CEO. The company withdrew its 2025 financial outlook, citing unexpectedly high medical costs and scrutiny. Shares plummeted following a series of setbacks, including a recent earnings miss and the high-profile case surrounding the death of executive Brian Thompson.

Physician and Iraq war veteran Manan Trivedi said that he finds it "very encouraging" that the Democratic Congressional Campaign Committee has targeted his second attempt to unseat Republican Congressman Jim Gerlach.

Cognizant on Tuesday announced that it has entered into a definitive agreement to purchase Health Care Service Corporation’s (HCSC) subsidiary TMG Health.

DANAPUR: The ministry of defence has approved an Augmented Armed Forces Clinic (AAFC) at the Danapur Cantonment with the sole aim of providing better and advanced medicare, particularly to ex-servicemen, under the contributory health scheme.

The doctors in the city have demanded strict implementation of a 2010 Act that protects them and their hospitals from attacks by patients’ relatives.