Managed Care Year-End Recap

Key issues, trends and regulatory updates affecting the Medicare Advantage, Managed Medicaid and Commercial marketplace

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Healthcare & Life Sciences, Health Solutions

Anyone Home? Recent Acquisitions by Humana, UnitedHealth Group and CVS Health/Aetna

November 04, 2022—Medicare Advantage enrollment reached 28.4 million in 2022, accounting for 48% of potential enrollees and 55% ($427 billion) of total Medicare spending.

Corporate Finance, Forensic & Litigation Consulting, Healthcare & Life Sciences, Health Solutions

Rising Regulatory Scrutiny of RAF Scores

August 22, 2022—We highlight the heightened regulatory environment associated with RAF scores and the importance of documentation to ensure accurate RAF scores.

Corporate Finance, Health Solutions, Healthcare & Life Sciences

Transparency in Coverage Rule Is Only the Beginning

December 01, 2022—The Transparency in Coverage final rule, applicable to commercial insurers, follows the Hospital Price Transparency rule by 18 months.

Health Solutions, Healthcare & Life Sciences

Recent CMS Actions on State Requests to Control Medicaid Drug Expenditures

November 10, 2022—Outpatient prescription drugs are an optional Medicaid benefit, yet all 50 states provide the benefit as a key component of comprehensive medical coverage.

Health Solutions, Healthcare & Life Sciences

Spotlight on Recent Federal Regulatory Actions Open for Public Comment

November 18, 2022—CMS’ proposed rule to streamline eligibility processes in Medicaid and solicitation of public comment on the creation of a national provider database.

Health Solutions, Healthcare & Life Sciences

Star Ratings: What’s Ahead

November 03, 2022—As Q4 approaches Medicare enrollees look forward to the Star Ratings tool, the tool that measures an enrollee’s experience with a health plan.

Corporate Finance & Restructuring, Healthcare & Life Sciences

Federal Regulatory Tracker

November 22, 2022—FTI Consulting’s regulatory tracker highlights select anticipated or pending U.S. Department of Health and Human Services actions that may impact Medicare.

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