Managed Care Year-End Recap

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

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.

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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.

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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.

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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.

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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.

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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.

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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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