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Higher medical costs will hurt 2023 earnings, Humana reports
Humana is expecting higher medical costs and lower Medicare Advantage enrollment to hurt its year-end earnings. -
Appeals court upholds UnitedHealth win in facility fee case
A federal appeals court upheld UnitedHealth Group's win in a class-action lawsuit by more than 200 physicians who said they were not paid facility fees for office-based surgeries. -
Labor Department sues BCBS Minnesota over provider tax on self-funded plans
Blue Cross and Blue Shield of Minnesota incorrectly imposed a state provider tax on self-funded health plan customers and violated its fiduciary duties under the Employee Retirement Income Security Act of 1974, according to a lawsuit filed against the payer by the Labor Department on Jan. 12. -
Consolidation, vertical integration on the rise in Medicare Advantage: MedPAC
Medicare Advantage insurers are increasingly becoming providers too, according to the Medicare Payment and Advisory Commission's 2024 status report. -
MedPAC: Medicare Advantage will receive estimated $88B in overpayments in 2024
Coding intensity and the types of enrollees who select Medicare Advantage plans will drive an additional $88 billion in payments to the program in 2024 compared with what traditional Medicare would receive, according to estimates from the Medicare Payment and Advisory Commission. -
Hospitals aren't breaking up with Medicare Advantage, UnitedHealth says
Though some contract negotiations with providers came "down to the wire" last year, UnitedHealthcare executives said the payer did not see more contract splits than usual in 2023. -
RSV vaccines drove rising Medicare Advantage costs, UnitedHealth execs say
RSV vaccinations brought more older adults to their primary care offices in the last months of 2023, one factor behind rising medical costs in Medicare Advantage, UnitedHealth Group executives said. -
UnitedHealth Group posts $5.5B profit in fourth quarter
UnitedHealth Group recorded double-digit growth in revenue year over year across its core lines of business at UnitedHealthcare and Optum, according to the company's fourth quarter earnings report released Jan. 12. -
What's going wrong with Medicaid redeterminations
Outdated eligibility systems and staff shortages are making the Medicaid redetermination process more difficult, state officials told KFF. -
The Medicare Advantage landscape in 2024: 10 updates
More seniors and dual-eligible individuals continue to enroll in Medicare Advantage plans, but the number of plans available decreased in 2024, according to an AHIP report published Jan. 9. -
ACA signups surpass 20 million for the 1st time
Over 20 million people have enrolled in individual insurance plans on the ACA exchange for 2024, CMS said Jan. 10. -
Pennsylvania launches website for appealing denied health insurance claims
The Pennsylvania Insurance Department has launched an online independent appeal process for state residents who believe their health plan wrongly denied a medical claim. -
Cigna to launch weight loss management program through Evernorth
The Cigna Group is getting ready to launch a new program that offers employers and health plan sponsors a way to manage obesity, diabetes and cardiovascular disease using weight loss drugs, or GLP-1s. -
6 American companies ranked among world's largest insurers
UnitedHealth Group is the world's largest insurance company by net premiums for the ninth year in a row, according to AM Best's annual ranking of global insurers published in January. -
CVS braces for more Medicare Advantage pressure
Medical costs for 2023 may be higher than CVS Health projected, CFO Thomas Cowhey said. -
Alignment Health grows its Medicare Advantage membership by 44%
Alignment Health is beginning 2024 with 155,000 Medicare Advantage members. -
Mark Cuban's drug co. inks partnership with startup payer
Mark Cuban's Cost Plus Drug Co. announced a new partnership Jan. 9 with startup insurance provider Sidecar Health. -
Another state mulls Medicaid work requirements
Idaho is the latest start considering Medicaid work requirements, the Idaho Capital Sun reported Jan. 9. -
Walgreens to pay Humana $360M to settle drug pricing lawsuit
Walgreens will pay Humana $360 million to settle a lawsuit alleging the pharmacy inflated its drug prices. -
CMS to terminate Illinois insurer's Medicare Advantage drug plan following low star ratings
CMS is terminating Chicago-based Zing Health's Medicare Advantage prescription drug plan at the end of 2024 following three consecutive years of star ratings below three stars.
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