Payers have faced state penalties in 2024 for slow reimbursements, improper claims denials, or the sale of unapproved products. 11 recent examples of payers fined or agreeing to settlements with ...

Eighteen insurers have exited Medicare Advantage markets for 2025, with more than 1.8 million people currently enrolled in plans that will not exist next year, according to OliverWyman. Market exits ...

Subsidiaries of Aetna and Humana received millions in Medicare Advantage overpayments in 2017 and 2018, the HHS Office of Inspector General alleged in audits published Sept. 25. The OIG estimated that ...

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Elevance Health is laying off 123 employees in Southern California, according to regulatory documents filed with the state Oct. 14. Elevance will lay off 59 employees at Anthem Blue Cross in Woodland ...

Centene is the latest insurer challenging CMS' star ratings in court. In a lawsuit filed Oct. 22, Centene asked a federal judge to require CMS to recalculate its star rating without including a secret ...

Moda Health is discontinuing all individual Medicare Advantage plans and will no longer offer MA plans in Oregon for 2025. Premera Blue Cross will not offer Medicare Advantage plans in 2025. MVP ...

Oscar Health is rolling out new plans for 2025. The insurer will offer individual plans in 504 markets in 18 states, according to an Oct. 21 news release. Oscar will add new markets in Texas, Oklahoma ...

Gordon Smith has been elected to Humana's board of directors. Mr. Smith currently serves as an operating advisor for private equity firm Clayton, Dubilier & Rice, according to an Oct. 23 Humana news ...