Medicare Advantage plans must comply with new network adequacy and health equity standards in 2025. Here are five policy changes taking effect in 2025: CMS will require Medicare Advantage plans to ...

HHS' Office of Inspector General has issued a special fraud alert about the risks of fraud and abuse in certain marketing and compensation arrangements related to Medicare Advantage. The December ...

CMS revised the star ratings for some Medicare Advantage plans and introduced major proposed reforms to the program in recent weeks. Humana misrepresented the providers its Medicare Advantage plans ...

Sanford Health Plan is expanding its Medicare Advantage offerings to more rural communities. In December, Sanford Health Plan, part of Sioux Falls, S.D.-based Sanford Health, partnered with Lincoln, ...

Enrollment in ACA plans hit a record high of 21.4 million in 2024, driven by premium subsidies. The enhanced ACA subsidies, which offer premium assistance to individuals earning up to 400% of the ...

Sacramento, Calif.-based Sutter Health has named Aparna Abburi as senior vice president of population health and health plan services and CEO of Sutter Health Plan. Ms. Abburi previously held ...

The prices for some GLP-1s have dropped significantly in recent years for individuals covered by Medicare and commercial insurance, according to a new report from HHS. In 2024, the U.S. list prices ...

Priority Health has closed on its purchase Physicians Health Plan of Northern Indiana, a Fort Wayne-based payer with more than 50,000 members in Indiana and Ohio. The acquisition was first announced ...

Georgia will award Medicaid contracts to four Medicaid managed care organizations. According to a notice published Dec. 2, the agency plans to grant Medicaid contracts to Humana, CareSource, Molina ...

Aetna is laying off 164 remote employees "due to an unexpected loss of contract in Kansas." The layoffs will take place in February 2025, according to regulatory documents filed with Connecticut ...

UnitedHealth Group expects revenues of up to $455 billion in 2025. The company hosted its annual investor conference on Dec. 4. UHG CEO Andrew Witty abruptly canceled the event about one hour after it ...

L.A. Care Health Plan has named Martha Santana-Chin as its next CEO. Previously, Ms. Santana-Chin served as plan chief product president for the California market at Centene's Health Net. She succeeds ...