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Health Plan Accountability Update: October 2025
The AHA May 29 submitted a letter to the Centers for Medicare & Medicaid Services responding to a request for information regarding Medicare Advantage data, urging CMS to increase oversight of the program.
Senate report says UHG used ‘aggressive strategies’ to increase MA payments
A Senate Judiciary Committee report released Jan. 12 found that UnitedHealth Group used “aggressive strategies” to maximize its Medicare Advantage risk-adjustment scores and collect higher payments from diagnoses of MA enrollees.
AHA podcast: How Mobile Training Is Saving Lives in Rural Iowa
Tina Eden, R.N., CEO of Virginia Gay Hospital, and Jacinda Bunch, Ph.D., R.N., assistant professor at the Iowa College of Nursing and senior advisor to Simulation in Motion-Iowa, or SIM-IA, dive into how this mobile clinical education program is delivering high-impact simulation training directly to rural hospitals and EMS teams.
AHA, other groups: It’s wrong to tell hospitals they ‘are to’ complete drug acquisition cost survey
Several health care groups, including the AHA, Jan.
CMS issues RFI on effort to revamp Medicare claims system
The Centers for Medicare & Medicaid Services has released a request for information seeking input on replacing its Medicare claims processing system with a real-time, cloud-based platform.
AHA urges MedPAC to recommend higher payment updates ahead of January meeting
The AHA Jan. 9 urged the Medicare Payment Advisory Commission to consider, during its next meeting Jan. 15-16, higher payment updates for the inpatient and outpatient prospective payment systems than those discussed in December and to examine Medicare Advantage’s role in access to care and provider financial stability.
1st Circuit denies stay, upholds district court’s halt of 340B rebate program
The 1st U.S. Circuit Court of Appeals Jan. 7 denied the government’s motion for a stay in a lawsuit filed by the AHA, the Maine Hospital Association and four safety-net health systems challenging the Department of Health and Human Services’ 340B Rebate Model Pilot Program. This means that the program remains on hold.
CMS releases form for submitting provider complaints on Medicare Advantage plans
The Centers for Medicare & Medicaid Services has implemented an online form for providers to submit complaints regarding Medicare Advantage plans.
Applications open for fifth round of Medicare-funded GME residency slots
The application period has opened for hospitals to apply for the latest allocation of Medicare-funded graduate medical education residency slots under Section 126 of the Consolidated Appropriations Act of 2021.