Medicare Advantage | Health Law

March 30, 2026

OIG Releases New Compliance Program Guidance for Medicare Advantage Organizations

For the first time in more than two decades, the U.S. Department of Health and Human Services, Office of Inspector General (OIG) released new Industry Segment-Specific Voluntary Compliance Program Guidance (ICPG) for Medicare Advantage Organizations (MAOs). This new Medicare Advantage ICPG broadens the scope of the guidance’s application and serves as a key resource for...

Bipartisan Budget Act / Medicare / Medicaid

April 9, 2019

CMS Continues Expansion of Supplemental Benefits in Medicare Advantage Plans

Last week, the Centers for Medicare and Medicaid Services (“CMS”) announced increased flexibility for Medicare Advantage health insurance plans to offer supplemental benefits (those benefits not covered under Medicare Parts A or B). Beginning in 2020, Medicare Advantage plans may offer chronically ill enrollees supplemental benefits that are not necessarily health-related but are reasonably expected...

Medicare / Medicaid

January 15, 2019

Changes to Medicare Advantage Risk Adjustment Model Proposed to Phase-In Beginning 2020

On December 20, 2018, CMS announced the first part of its two-part advance notice to implement changes to the Medicare Advantage (“MA”) risk adjustment methodology for 2020 (the “Advance Notice”), which can be found here. A key element of the CMS proposal in the Advance Notice is to incorporate into the risk adjustment methodology the...

Healthcare Payment and Reimbursement

May 14, 2018

CMS Expands Health Related Supplemental Benefits in Medicare Advantage Plans

Last month, the Centers for Medicare and Medicaid Services (“CMS”) announced new flexibility in what Medicare Advantage plans may cover as “supplemental health care benefits.” The announcement was part of CMS’ release of Calendar Year 2019 Medicare Advantage and Part D Rate Announcement and Call Letter. The Medicare Managed Care Manual (Chapter 4, Section 30.1)...

Tagged: Medicare Advantage

OIG Releases New Compliance Program Guidance for Medicare Advantage Organizations

Changes to Medicare Advantage Risk Adjustment Model Proposed to Phase-In Beginning 2020

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