CMS has withdrawn its appeal of a judge's decision directing the agency to increase UnitedHealthcare's star ratings for its Medicare Advantage plans for 2025. Attorneys for the agency filed a notice ...

Almost every state has completed the unwinding of Medicaid continuous coverage, but the process is still causing problems for insurers. Elevance Health saw its Medicaid membership decline by 15% from ...

Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites. 1. Appalachian ...

In 2024, Inland Empire Health Plan achieved significant growth through the expansion of healthcare facilities, recognition on top industry rankings, strengthened partnerships with local and community ...

CMS' proposed Medicare Advantage rates for 2026 are moving in the right direction, but still "insufficient" to cover rising costs in the program, according to Elevance Health executives. On a Jan. 23 ...

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Little Rock-based Arkansas Blue Cross and Blue Shield is discussing a potential merger with Cambia Health Solutions, Arkansas Business reported Jan. 21. Arkansas Business cited a source with knowledge ...

A Texas lawmaker has introduced a bill that would prohibit payers from using artificial intelligence to delay, deny or modify claims, NBC affiliate KXAN reported Jan. 21. The bill from Sen. Charles ...

Elevance Health posted nearly $6 billion in net income in 2024, according to the company's year-end earnings report published Jan. 23. Total revenues in the fourth quarter were $45.4 billion, a 6.6% ...

Banner|Aetna has named Victoria Coley as CEO. Tom Grote, the joint venture's former CEO, has retired, according to a Jan. 24 news release. Ms. Coley was most recently chief medicare officer for ...

An Indiana lawmaker has reintroduced legislation that would cap all prior authorization rates at 1%, the Indiana Capital Journal reported Jan. 23. The proposed bill would also ban prior authorization ...

CMS issued nearly $2.5 million in fines on Jan. 17 across multiple health plans for Medicare contract violations related to Part C maximum out-of-pocket limits and cost-sharing requirements, and Part ...