RADAR on Medicare Advantage | Despite Trump Transition Chaos, Medicare Advantage Plans Must ‘Keep Calm’

In the first few weeks of Donald Trump’s second presidency, Medicare Advantage plans faced a tremendous amount of uncertainty as the White House threatened to pause federal financial assistance activities, issued multiple executive orders outlining the new administration’s priorities, and targeted diversity, equity and inclusion (DEI) initiatives

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Medicare Advantage RADV Final Rule Changes: With an Expected Audit Recovery of Nearly $5B in Next 10 Years, Will Your Plan Face an Audit?

Medicare Advantage RADV Final Rule Changes: With an Expected Audit Recovery of Nearly $5B in Next 10 Years, Will Your Plan Face an Audit?

The Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) audit is a vital process conducted by the Centers for Medicare and Medicaid Services (CMS) to ensure the correctness of payments to MA plans. CMS determines monthly payments based on the health and demographic characteristics of each member,

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