The U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) recognizes the impact that the cyberattack on UnitedHealth Group’s subsidiary Change Healthcare/Optum in late February (the Incident) has had on health care operations across the country. CMS is in frequent communication with UnitedHealth Group and Change/Optum and will…
Read MoreOn April 1, 2024, the Centers for Medicare & Medicaid Services (CMS) finalized the Calendar Year (CY) 2025 Rate Announcement for the Medicare Advantage (MA) and Medicare Part D Prescription Drug (Part D) Programs that updates payment policies for these programs and ensures payment accuracy. The Rate Announcement complements policies in the CY 2025 MA…
Read MoreOn February 6, 2024, CMS released an FAQ memo clarifying how a new Medicare rule (Final Rule) and the Affordable Care Act impact the use of AI and algorithms by MA organizations in making Medicare Advantage coverage determinations. The final rule (CMS Final Rule, CMS-4201-F) became applicable to coverage beginning January 1, 2024. The 2024 Medicare Advantage…
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