Medicaid could spend $29.9 billion on drugs to treat type 2 diabetes and weight loss, according to a report from HHS' Office of Inspector General. The report, published Dec. 19, reviewed Medicaid ...

Independent Health will pay up to $98 million to settle allegations a now-defunct subsidiary knowingly submitted invalid diagnoses to boost Medicare Advantage payments. According to a Dec. 20 news ...

Fewer people are enrolling in ACA marketplace plans than last year, according to CMS data. As of Dec. 4, 5.4 million people had enrolled in federal ACA marketplace plans. During the same time last ...

Georgia's Medicaid contract awards could cause three in four Medicaid recipients in the state to switch plans, according to Centene CEO Sarah London. The state said it would grant Medicaid contracts ...

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. Bayhealth, based ...

One in four people in the United States struggle with mental health, and leaders agree that today's system lacks the resources to support them. Issues such as prolonged wait times, inadequate ...

Startup insurer Sidecar Health has inked a transparent pricing agreement with The Ohio State University Wexner Medical Center. The fixed-price model removes prior authorizations and network ...

HHS' Office of Inspector General has issued a special fraud alert about the risks of fraud and abuse in certain marketing and compensation arrangements related to Medicare Advantage. The December ...

Payers partnered with Google, Instacart and other tech companies in 2024. Here are eight deals to note from this year: Molina Healthcare partnered with Instacart in Michigan to address food insecurity ...

Our healthcare system badly lags other industrialized nations in terms of what we spend and the outcomes we achieve, and the culprit is fairly obvious: we spend five times our peer nations on ...

L.A. Care Health Plan named Martha Santana-Chin as its next CEO in December. McLaren Health Care named Jessica Cromer as president and CEO of the McLaren Integrated HMO Group in December, the ...

In November, UnitedHealthcare prevailed in its lawsuit against CMS regarding the methodology used to calculate its 2025 Medicare Advantage star ratings. Humana, Centene, Elevance Health, and BCBS ...