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 ...

CMS is launching its long-term enhanced accountable care organization design, or LEAD, model at the end of 2026, following the conclusion of the ACO realizing equity, access and community health model ...

UnitedHealthcare is delaying a coverage policy that would have sharply restricted remote physiologic monitoring services for most chronic conditions. The policy, which had been scheduled to take ...

A group of 33 NorthStar anesthesia providers filed a lawsuit against Aetna and Cigna over an alleged $4.1 million in No Surprises Act underpayments, according to Dec. 8 filings in Connecticut’s U.S.

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 ...

Humana’s Louisiana business received at least $10.5 million in Medicare Advantage overpayments in 2017 and 2018, according to an audit report from HHS’ Office of Inspector General. The audit, ...

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 ...

Evry Health CEO and co-founder Chris Gay thinks the health insurance industry could eliminate prior authorizations entirely, but only if providers meet insurers halfway. On the Becker’s Payer Issues ...