Ilene MacDonald

A new KFF brief offers an overview of premiums and benefits in 2026 Medicare Advantage (MA) plans based on data from the Centers for Medicare & Medicaid Services’ Landscape and Benefits files.

A new study by Deft Research uncovers how Medicare members use digital health tools provided by their insurers, their providers, and other third parties to manage their health and navigate their coverage.

A U.S. District Court judge from Massachusetts has blocked major revisions to the nation’s childhood vaccine schedule and suspended members of the reorganized Advisory Committee on Immunization Practices (ACIP).

The Trump administration on Wednesday announced a major new program to curb fraud in Medicare and Medicaid, unveiling a series of aggressive oversight and enforcement measures aimed at protecting patients, strengthening program integrity, and reducing federal spending.

Gateway Health Plan improperly received an estimated $4.3 million in Medicare Advantage payments after submitting diagnosis codes that federal auditors say were not supported by medical documentation, according to a new compliance audit from the Department of Health and Human Services Office of Inspector General.

Medicare Advantage (MA) enrollment topped 35 million as of February 2026, but new data from Centers for Medicare & Medicaid Services (CMS) shows the program entering a period of slower growth as insurers adjust strategies amid rising costs, reduced margins, and regulatory pressure.

The Department of Health and Human Services on Thursday announced plans to radically restructure the department, cutting thousands of full-time jobs, centralizing units, and prioritizing ending the country’s chronic illness epidemic. HHS said the restructuring will save taxpayers $1.8 billion a year.

It will take nearly $95 billion in discretionary funding in fiscal year 2026 to “Make America Healthy Again,” according to the Trump Administration’s budget for the Department of Health and Human Services (HHS).

The Health Equity Index (HEI) reward in the Medicare Advantage Star ratings program was rebranded in the final rate notice released on Monday.

A newly released Office of Inspector General (OIG) audit found that most of the high-risk diagnosis codes that the St. Louis-based Medicare Advantage (MA) organization submitted to the Centers for Medicare & Medicaid Services didn’t comply with federal requirements.

The agency said the move is part of the administration’s crackdown on fraud, waste, and abuse in the Medicare program.

A new report from UnidosUS, a Latino civil rights and advocacy group, warns that the federal policy changes are poised to reverse 14 years of progress in Latino health coverage and urges Congress to reverse the policy decisions.

A new machine-learning–driven risk-adjustment model could significantly reshape how Medicare Advantage (MA) plans are paid—and potentially save Medicare billions in overpayments each year.

Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. spent nearly three hours before the House Ways and Means Committee on Thursday morning defending the Trump administration’s health agenda, fielding pointed questions on vaccines, Medicaid cuts, rural hospital funding, food policy, fraud enforcement, and the federal response to chronic disease. The hearing was scheduled to continue after a recess and Kennedy was also due to appear before the House Appropriation Committee on Tuesday a

The Centers for Medicare & Medicaid Services (CMS) on Friday released a proposed rule aimed at modernizing prior authorization for prescription drugs. The rule would require faster prior authorization decisions, expand electronic prior authorization to drugs, and increase transparency across federal programs.

The Centers for Medicare & Medicaid Services (CMS) on Friday proposed significant updates to Medicare hospital payment policies for fiscal year 2027, including a nationwide expansion of its long-running joint replacement payment model that could improve care coordination while lowering costs for beneficiaries.

The Centers for Medicare & Medicaid Services (CMS) has finalized major changes to Medicare Advantage (MA) and Part D marketing rules for 2027, reshaping how agents, brokers, and third party marketing organizations (TPMOs) can engage with beneficiaries.

After months of uncertainty, the Centers for Medicare & Medicaid Services (CMS) gave Medicare Advantage plans a gift with the 2027 Final Rate Notice and Final Rule. The agency increased payments well above its January proposal in the Advance Notice and held off on changes to the risk adjustment model, moves that many view as short-term relief for Medicare Advantage plans facing high medical costs.

Medicare Advantage plans will receive a higher net payment increase in 2027 than originally proposed in the Advance Notice.

The Centers for Medicare & Medicaid Services (CMS) on Thursday released the 2027 Medicare Advantage and Part D Final Rule, making changes to Star ratings and updates to supplemental benefits. Here is a first look at what the agency finalized. Watch RISE for more analysis in the week ahead.