Navigating a Rocky Relationship—Provider-Managed Care Disputes Continue

Currently, more than half of all eligible Medicare beneficiaries are enrolled in Medicare Advantage (MA) plans administered by private payers rather than traditional Medicare. As the number of MA enrollees grows, so, too, do payment disputes between MA plans and providers, as well as government oversight of the MA program. This article, Navigating a Rocky Relationship—Provider-Managed Care Disputes Continue, examines recent trends in MA audits, litigation involving MA plans, and intervention by the Centers for Medicare & Medicaid Services (CMS).