The Trump administration is looking to target 'program integrity' within the Affordable Care Act marketplace with a new proposed rule, while also reducing funding for the ACA navigator program to $10 ...
A federal judge is allowing a lawsuit against UnitedHealth Group to partially move forward, which alleges the company used an artificial intelligence algorithm to wrongfully deny Medicare Advantage ...
Chiquita Brooks-LaSure, the CMS administrator during the Biden administration, is joining The Century Foundation, a progressive think tank, as a senior fellow. As a full-time senior fellow, Ms. Brooks ...
UnitedHealth Group and Amedisys have proposed selling a minimum of 128 home health and hospice facilities as part of their efforts to address competitive concerns arising from their $3.3 billion ...
The country's largest payers reported year-over-year increases in medical cost ratios. CVS Health reported the highest medical benefit ratio at 92.5%, driven by increased utilization, the unfavorable ...
Healthcare payer marketers are caught between a rock and a hard place: They are responsible for driving growth for their organizations, yet are hamstrung by their legal and compliance colleagues in ...
Atlanta-based Sonder Health Plans is rapidly expanding while aiming to keep its personalized service for members. The health plan added 14,000 new members for 2025, more than tripling its enrollment, ...
Aetna has reversed course on a policy change involving reimbursement rates for services provided by nurse practitioners and nurse midwives. Originally set to take effect on April 1, the company said ...
Centene has moved to dismiss the lawsuit it filed challenging its Medicare Advantage star ratings in court. In October, Centene asked a federal judge to require CMS to recalculate its star rating ...
The nation's largest payers have filed their fourth-quarter earnings reports, revealing which recorded the largest profits in 2024. 1. UnitedHealth Group: $14.4 billion Total net earnings in 2024 were ...
Blue Cross Blue Shield of North Carolina is the highest-ranked health insurer on Forbes' annual ranking of America's best large employers. The publication released its annual ranking of the best ...
Multiple prior authorization reform bills are in the works in the Montana state legislature, KFF Health News reported Feb. 13. Three things to know: 1. State Rep. Jonathan Karlen is sponsoring two ...