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CMS' 2025 Medicare Advantage rates lower than expected, Humana says
CMS' proposed Medicare Advantage rates for 2025 are lower than Humana predicted, the company said in a filing with the Securities and Exchange Commission Feb. 5. -
J&J worker accuses employee health plan of drug benefits mismanagement
A Johnson & Johnson employee is suing the New Brunswick, N.J.-based pharmaceutical giant for allegedly mismanaging workers' prescription drug benefits and violating its fiduciary duties under the Employee Retirement Income Security Act. -
BCBS Massachusetts launches reproductive clinical team, expanded services
Blue Cross Blue Shield of Massachusetts is launching a set of new initiatives aimed at ensuring access to reproductive care services. -
Complaint filed with FTC over Deloitte's Medicaid eligibility software
A software Texas uses to process Medicaid renewals is not working accurately, causing people to be wrongfully disenrolled from the program, advocates allege. -
Cigna isn't done with Medicare
Cigna is selling its Medicare plans, but Evernorth, its health services arm, is still in the business. -
Cigna posts $1B profit in Q4
The Cigna Group is projecting $235 billion in revenue by the end of 2024 and recorded double-digit growth in the fourth quarter across its core lines of business at Evernorth Health Services and Cigna Healthcare, according to the company's year-end earnings report published Feb. 2. -
Florida Blue adds Medicare-focused primary care center
Florida Blue has opened a primary care center for Medicare beneficiaries and Florida Blue members over 50. -
Louisiana physicians vote 'no' on Elevance-BCBS deal
The Louisiana State Medical Society has voted against the proposed sale of Blue Cross Blue Shield of Louisiana to Elevance Health. -
Mississippi prior authorization bill makes 2nd go-round, but governor has other plans
The Mississippi Senate has advanced an updated version of a prior authorization bill that was vetoed by the governor last year, but this version's chances of being signed into law remain unlikely, the Magnolia Tribune reported Jan. 31. -
15 sentenced in California for $40M health insurance fraud scheme
The last of 15 defendants have been sentenced in Santa Clara, Calif. for their roles in a $40 million statewide insurance scam involving "overpriced and unneeded" telehealth prescriptions and medical devices. -
Bridging the Health Equity Gap in Rural America Through Exceptional Provider Support
About 60 million people—nearly one in five Americans—live in rural areas and depend on their local hospitals for care. But rural American health care is fragile business. -
Medicare Advantage in the headlines: 9 recent updates
Challenges loom for Medicare Advantage in 2024, with payers reporting rising medical costs and lower growth expectations for the year. -
States ranked by ACA enrollment growth in 2024
Open enrollment for the ACA exchanges is finished in most states and a record 21.3 million people are enrolled — a 30% increase year over year, or 5 million people. -
Self-funded plans on the rise
The share of U.S. employees in healthcare plans funded by their employer rose from 2015 to 2021, a study published in the January issue of Health Affairs found. -
ACO participation grows for 2024
Nearly half of people with traditional Medicare are aligned with Accountable Care Organizations, CMS said Jan. 29. -
Dr. Sachin Jain: 5 fixes for Medicare Advantage
Five key changes could improve Medicare Advantage, SCAN Group CEO Sachin Jain, MD, wrote in Forbes Jan. 30. -
Humana to add 3 more CenterWell markets
Humana is expanding its primary care business for seniors into three new markets in 2024 and adding new centers in eight existing markets. -
No Surprises Act prevents 10M surprise bills, insurance groups say
The federal No Surprises Act is estimated to have prevented more than 10 million surprise medical bills during the first nine months of 2023, according to a Jan. 26 report from AHIP and the Blue Cross Blue Shield Association. -
Why Blue Shield of California's Medicaid plan is paying for members to get GEDs
Blue Shield of California Promise Health Plan is now offering its Medicaid members in Los Angeles and San Diego counties the opportunity to earn their GED diploma at no cost, a first of its kind program in the state. -
Lawmakers urge more action on Medicare Advantage overpayments
Two lawmakers are asking CMS to do more to curb overpayments to the Medicare Advantage program.
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