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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

ICHRA broker platform Remodel Health has raised more than $100 million in growth funding. Remodel offers a platform to support employers and employees with launching and accessing ICHRA plans, ...

Payers expanded their reach into the provider space through acquisitions in 2024. Elevance Health picked up specialty care providers and launched a new foray into primary care. UnitedHealth Group's ...

New York City must pay for the cost of any plan it offers to its retired employees, the state's appeals court ruled, complicating its path to implementing a Medicare Advantage plan. The city has ...