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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

North Carolina has fined UnitedHealthcare $3.4 million following a four year investigation into the company's claims handling practices involving balance billing. The investigation focused on the ...

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 ...

UnitedHealthcare, in collaboration with the Health Action Council, has released a report analyzing the economic impact of obesity on employer's healthcare costs. The study, which analyzed data from ...

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 ...

Blue Cross Blue Shield of Massachusetts has promoted Prem Somasundaram to CIO and named Dennis Charland Jr. as senior vice president of commercial and pharmacy sales. Mr. Somasundaram most recently ...