BlueCross BlueShield of Tennessee agreed to a settlement with employees who said the company denied their COVID-19 vaccine exemption requests, thus affecting their careers, according to a Dec. 8 ...
CMS is seeking input on whether its risk adjustment system disadvantages smaller Medicare Advantage plans, and one regional plan CEO says the answer is an emphatic yes. In its 2027 proposed MA rule, ...
UnitedHealth Group has released findings from multiple independent reviews of its business practices following a June pledge from CEO Stephen Hemsley to conduct a transparent and comprehensive ...
CMS will launch a voluntary pilot in 2026 to gather service-level data on prior authorization determinations and appeals in Medicare Advantage, according to a Dec. 16 memo. After the pilot, the agency ...
AHIP’s board of directors has elected Humana President and CEO Jim Rechtin as board chair effective Jan. 1. Mr. Rechtin succeeds Pat Geraghty, who announced his retirement after leading GuideWell and ...
The American Hospital Association and Federation of American Hospitals are calling on Elevance Health to rescind a new policy that would penalize hospitals for using out-of-network providers. In a Dec ...
Minnesota is rehabilitating UCare, according to a Dec. 17 court filing. The state will take over the insurer’s assets and finances. While providers cannot collect payment from UCare during this time, ...
Digital identity wallet service ID.me entered into a contract with CMS, with rollouts to improve secured access and user experience coming to Medicare.gov in early 2026. ID.me will act as an identity ...
A healthcare experience that offers an integrated, holistic approach is more critical than ever. It transcends traditional healthcare approaches by emphasizing the importance of putting the patient at ...
California’s Department of Managed Health Care fined three Centene-owned health plans a total of $1.7 million over concerns about not meeting reporting rate standards for timely access of appointments ...
Health plans were early adopters of AI, using it to streamline claims processing, support call centers and manage utilization. Now, they’re ramping up AI deployment to enhance member experience, ...
Kaiser Permanente’s Northern and Southern California health plans have been named the highest-quality commercial plans in the state by the California Center for Data Insights and Innovation. The ...
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