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What We're Reading: MA Plans Overbill; Biden Cancer Initiative Suspends Activities; CMS to Cover Some Acupuncture
Medicare Advantage (MA) plans have overbilled the government by nearly $30 billion the past 3 years alone, and CMS said it is moving forward with plans to attempt to get back $1 billion; the Biden Cancer Initiative is suspending operations while its founder, former Vice President Joe Biden, runs for president; CMS said Medicare will cover acupuncture for some patients with chronic low back pain.
CMS Seeks to Recoup $1 Billion From $30 Billion in Overpayments to MA Plans
Medicare Advantage plans have overbilled the government by nearly $30 billion the past 3 years alone, and CMS said it is moving forward with plans to attempt to get back $1 billion by 2020 from the private insurance plans, Kaiser Health News reported. The insurance industry is opposing the enhanced audits.
Biden Cancer Initiative Suspends Operations During Joe Biden's Presidential Campaign
The Biden Cancer Initiative is suspending operations while its founder, former Vice President Joe Biden, runs for president. The Hill reported that Greg Simon, president of the Biden Cancer Initiative, said the organization is “suspending activities given our unique circumstances.” The organization was launched in 2017 as an offshoot of the Obama administration's Cancer Moonshot program.
Medicare to Pay for Some Acupuncture for Low Back Pain
CMS said Medicare will cover acupuncture for patients with chronic low back pain enrolled in research to see if the treatment is effective. The proposal is part of the government’s effort to develop alternatives to opioids for pain. Eligible studies must be sponsored by the National Institutes of Health or approved by CMS.
AI in Health Care: Balancing Governance, Innovation, and Trust
September 2nd 2025In this conversation with Reuben Daniel, associate vice president of artificial intelligence at UPMC Health Plan, we dive into how UPMC Health Plan builds trust with providers and members, discuss challenges of scaling AI effectively, and hear about concrete examples of AI's positive impact.
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Team Coordination, Data Sharing Help Prioritize Value in Cardio-Renal-Metabolic Care
September 12th 2025Cardiologists, nephrologists, and payers met in Scottsdale, Arizona, on August 26, 2025, to share insights on how team members can work together, empowered by data, to achieve value-based management of cardio-renal-metabolic syndrome.
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