Insurers on the ACA marketplace denied around one in five in-network claims in 2023, according to a report from KFF published Jan. 27. Plans sold on the federal ACA marketplace are required to report ...

CMS has withdrawn its appeal of a judge's decision directing the agency to increase UnitedHealthcare's star ratings for its Medicare Advantage plans for 2025. Attorneys for the agency filed a notice ...

UnitedHealthcare is cutting more than 150,000 square feet of office space in Maryland Heights, Mo. as many of its employees continue to work remote or hybrid, the St. Louis Business Journal reported ...

GuideWell, the parent company of Florida Blue, is laying off 3% of its workforce across 29 states, First Coast News reported Jan. 22. "GuideWell is committed to providing access to quality health care ...

A Minnesota federal judge has given preliminary approval to UnitedHealth's agreement to pay $69 million to settle a class-action lawsuit alleging the company prioritized its business relationship with ...

Payers are trimming their workforces and cutting jobs due to financial or operational challenges, along with contract losses. Below are workforce reduction efforts or job eliminations that were ...

Almost every state has completed the unwinding of Medicaid continuous coverage, but the process is still causing problems for insurers. Elevance Health saw its Medicaid membership decline by 15% from ...

Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites. 1. Appalachian ...

CMS' proposed Medicare Advantage rates for 2026 are moving in the right direction, but still "insufficient" to cover rising costs in the program, according to Elevance Health executives. On a Jan. 23 ...

In 2024, Inland Empire Health Plan achieved significant growth through the expansion of healthcare facilities, recognition on top industry rankings, strengthened partnerships with local and community ...

An Indiana lawmaker has reintroduced legislation that would cap all prior authorization rates at 1%, the Indiana Capital Journal reported Jan. 23. The proposed bill would also ban prior authorization ...

Banner|Aetna has named Victoria Coley as CEO. Tom Grote, the joint venture's former CEO, has retired, according to a Jan. 24 news release. Ms. Coley was most recently chief medicare officer for ...