In five large counties, payers own more than one-third of the primary care market, according to a study published in the July issue of Health Affairs Scholar found. Payers, including Optum, Aetna, ...

Blue Cross and Blue Shield of Louisiana has lost its legal challenge against CMS over how its 2025 Medicare Advantage star ratings were calculated. On July 9, the U.S. District Court for the District ...

A silver-level insurance plan costs nearly 20% of the median monthly household income in Vermont, according to WalletHub. The personal finance company published a ranking of states spending the most ...

Last week, a coalition of more than 50 major health insurers signed a pledge at a Washington, D.C. summit to “simplify” prior authorization. Led by Secretary Robert F. Kennedy Jr. and Centers for ...

Elevance Health and the Blue Cross Blue Shield Association are suing LifeX Research Corporation, accusing the Georgia-based company of fraudulently using the insurers’ trademarks to sell fake health ...

On July 4, President Donald Trump signed the “One Big Beautiful Bill Act,” which includes major changes for employee benefits. 1. Starting January 1, individuals enrolled in bronze and catastrophic ...

Justice Department officials have questioned former UnitedHealth Group employees as part of an investigation into the company’s Medicare Advantage billing practices, The Wall Street Journal reported ...

CMS is implementing a final rule that will shorten the open enrollment period on the ACA exchange and create stricter eligibility verifications for enrollees. In a June 20 news release, the agency ...

Federal lawmakers have introduced a handful of bills aimed at speeding up prior authorization and cracking down on upcoding in Medicare Advantage. None of the introduced bills have been heard in ...

Louisiana Gov. Jeff Landry has vetoed a key provision from the state’s budget plan that would have required coverage of weight loss medications for state employees and their dependents for the ...

UnitedHealth Group will require some hybrid employees in Minnesota and Washington, D.C. to be in office four days per week starting July 7, the Minneapolis/St. Paul Business Journal reported. It is ...

CMS will raise limits for payments to Medicare Advantage brokers for 2026. According to a notice from CMS published June 18, plans can pay brokers up to $694 for new enrollments in MA plans, and $347 ...