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Harbor Health, an Austin, Texas-based insurer that also runs its own medical clinics, plans to acquire 27 Village Medical primary…
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Seven hospitals affiliated with Nashville, Tenn.-based HCA Healthcare filed a lawsuit Oct. 5 against Anthem Blue Cross and Blue Shield in Georgia, part of Elevance Health, alleging denied or underpaid claims, according to court records reviewed by Becker’s. Corpus Christi…
Higher use of medical services and prescription drugs, rather than rising inflation-adjusted prices, drove a recent uptick in commercial spending at Blue Cross Blue Shield of Massachusetts, according to a study published Oct. 5 in Health Affairs. The analysis was…
Medicaid members with behavioral health conditions pass through emergency departments, inpatient units and outpatient follow-up as though each were a separate system. For most plans it is, and the members who need coordination most are the least likely to get…
Presented by:
- Kristi Carney, Director of Behavioral Health, CareSource, Indiana Market
- Nishi Rawat, MD, Chief Clinical Officer and GM Care Navigation, Bamboo Health
Mitchell Evans will serve as Humana’s next Kentucky Medicaid CEO, according to an Oct. 6 LinkedIn post. According to Mr. Evans’ LinkedIn profile, he has spent more than 15 years with Humana, most recently as a national vice president for…
SCAN Health Plan has been expanding its co-branded Medicare Advantage plans for 2027, including through a partnership with Walmart. Walmart and SCAN are launching the SCAN Walmart Health Advantage HMO and SCAN Walmart Medicare Complete Chronic Special Needs Plan, also…
A federal judge has largely rejected Alignment Healthcare’s bid to throw out a former senior executive’s whistleblower lawsuit that accuses the Medicare Advantage insurer of financial mismanagement. Alignment’s former chief technology officer, Hakan Kardes, PhD, alleged in July that he…
Dispute activity under the No Surprises Act continues to evolve, court decisions are influencing the regulatory landscape, and the Final Rule could change how health plans and healthcare organizations approach key requirements. This session offers a data-driven look at where…
Presented by:
- Jennifer Forcash, Assistant Vice President Surprise Bill Solutions, Claritev
There will be at least six new carriers on ACA marketplaces in 2027, despite the continued pressures facing the wider market. Nationally, insurers have proposed a median 14% rate increase for 2027, the second straight year of double digit hikes.…
SCAN Health Plan and Sacramento, Calif.-based Sutter Health are bringing their co-branded Medicare Advantage plans to four more Northern California counties in 2027, up from six in 2026. SCAN and Sutter first announced their collaboration in 2025, with Sutter hinting…
Twelve insurers have announced they will stop offering individual ACA marketplace plans, either nationally or in specific states, after the 2026 plan year. The withdrawals come amid declining enrollment nationwide, rising premiums and the expiration of enhanced premium tax credits…
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Presenter: Mauricio Garcia Jacques, MD, MPH, Raport Inc
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