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 ...

Aetna is laying off 164 remote employees "due to an unexpected loss of contract in Kansas." The layoffs will take place in February 2025, according to regulatory documents filed with Connecticut ...

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, ...

Humana and CommonSpirit hospitals in Colorado will go out-of-network Jan. 1, 2025. The contract split applies to Humana Medicare Advantage plans, according to a statement CommonSpirit shared with ...

Sanford Health Plan is expanding its Medicare Advantage offerings to more rural communities. In December, Sanford Health Plan, part of Sioux Falls, S.D.-based Sanford Health, partnered with Lincoln, ...

Premera Blue Cross recognized the need for strong ethical commitments around AI even before the rise of ChatGPT and other easily accessible generative AI models. Adrian Mayers is chief information ...

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 ...

Medicare Advantage plans must comply with new network adequacy and health equity standards in 2025. Here are five policy changes taking effect in 2025: CMS will require Medicare Advantage plans to ...

Enrollment on the ACA marketplace reached 16.6 million consumers as of Dec. 18. The surge in enrollments comes after a slow start. As of Dec. 4, 5.4 million people had enrolled in federal ACA ...

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 ...

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 ...

2024 was a tumultuous year for Medicare Advantage. Increased government scrutiny, tighter CMS regulations, reduced base payments and rising healthcare costs are putting pressure on the program.