HCC / MA
CMS paid plans $13B more in CY 2027 and killed retrospective sweeps
The CY 2027 MA Rate Notice came in at +2.48% / +$13B, far above the January advance notice. But CMS finalized the exclusion of unlinked chart-review diagnoses, ending an estimated $7B annual capture p
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OIG's first major MA Compliance Program Guidance since 1999
In February 2026, HHS-OIG published the Industry-Specific Compliance Program Guidance for Medicare Advantage. It names by name the operational playbooks of MA-aligned medical groups as compliance risk
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The DOJ probe puts the in-home HRA playbook on trial
UnitedHealth's Q1 2026 SEC filing acknowledged a DOJ criminal investigation. Senator Grassley's 50,000-page majority staff report dissects the in-home HRA capture playbook. The fact pattern under pros
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