Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...

Explore 2025 managed care enforcement trends under the Trump administration. Learn about Department of Justice (DOJ) and ...

On January 14, the Department of Justice (DOJ) announced that five Kaiser Permanente affiliates agreed to pay $556 million to ...

George Witwer, CEO of Cavo Health Outperforms Machine Learning Tools with 96%+ HCC completeness, 2–4x Productivity Gains and Reduced Audit Risk Our platform delivers more accurate, audit-ready results ...

LEWES, Del., April 22, 2025 (GLOBE NEWSWIRE) -- John Snow Labs, the AI for healthcare company, today announced its new end-to-end Hierarchical Condition Category (HCC) coding engine designed to help ...

A Senate report accuses UnitedHealth Group of turning Medicare Advantage risk adjustments into a profit strategy.

Medicare Advantage remains an attractive option for Medicare beneficiaries, and enrollment has increased substantially, by 66 percent in the past six years. Also increasing, it seems, is coding ...

The MarketWatch News Department was not involved in the creation of this content. Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with ...

Kaiser Permanente (Kaiser) has agreed to pay $556 million to resolve False Claims Act litigation alleging improper Medicare Advantage risk-adjustment practices, according to the U.S. Department of ...

Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with Penguin Ai's HCC Coding & Risk Adjustment Snowflake Native App PALO ALTO, Calif., Jan.