About the Event
As Medicare Advantage (MA) continues to grow, now covering over half of all Medicare beneficiaries, questions around its cost to taxpayers and value to enrollees are increasingly central to the congressional agenda. Recent analyses show that upcoding alone could account for over $80 billion in annual overpayments, while prior authorization practices and limited transparency create administrative burdens and raise concerns about access and oversight.
With policymakers eyeing MA reforms as potential pay-fors in a year-end health package and CMS regulations on the horizon, this bipartisan, educational briefing will provide a forum to explore pragmatic, research-backed options for strengthening the program’s integrity without undermining beneficiary access. The discussion will focus on potential areas to revitalize the MA program with growing consensus, such as improving risk adjustment, addressing upcoding incentives, enhancing transparency, and reforming prior authorization.
Date: October 22, 2025
Time: 12:00 - 1:30 PM EST
Location: 50 Constitution Avenue Northeast, Washington, DC
Click here to RSVP for the event
Key Topics to be explored:
Overview of MA’s growth and fiscal impact
Risk adjustment and upcoding: recent changes, scope of the issue and policy options
Transparency challenges: vertical integration, supplemental benefits, plan performance, and data availability
Prior authorization: recent changes, patient and provider burden, impact on rural hospitals, reform momentum
Legislative and regulatory options under discussion for 2025 and potential year-end action