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An insurer reached a nearly $100 million settlement over allegations of overpayments, and CMS plans to sunset a value-based model over "unprecedented" costs. Here are seven Medicare Advantage updates ...

UnitedHealth Group has optimized its ability to increase Medicare Advantage members' sickness scores and corresponding government payments by directly employing thousands of physicians at Optum and ...

Climate change is becoming an increasingly urgent challenge for the health insurance industry. "The top trends that I am following are climate change and geriatric care," Pleasant Radford, Health ...

The year 2024 will be remembered as one full of unprecedented challenges and turmoil for the nation's largest healthcare company. From the tragic and targeted killing of UnitedHealthcare CEO Brian ...

While most Medicare Advantage plans offer dental benefits, few of these benefits are comprehensive, a study published Dec. 26 in JAMA found. Here are three things to note: More than 85% of Medicare ...

UnitedHealthcare and Tacoma, Wash.-based Virginia Mason Franciscan Health have reached a new multi-year contract. All UnitedHealthcare-insured patients will continue to have access to all of VMFH's ...

HHS' Office of Inspector General estimated three Medicare Advantage insurers received around $11.4 million in overpayments. The government watchdog published audits of three MA plans Dec. 23-26. The ...

UnitedHealth Group and home health company Amedisys have agreed to extend the deadline for a planned $3.3 billion merger due to a legal challenge by the Department of Justice. In a Dec. 26 regulatory ...

Payers have faced state penalties in 2024 for slow reimbursements, improper claims denials, or the sale of unapproved products. L.A. Care Health Plan will pay a $55 million penalty to California to ...

Independent Health will pay up to $98 million to settle allegations a now-defunct subsidiary knowingly submitted invalid diagnoses to boost Medicare Advantage payments. According to a Dec. 20 news ...

Humana and CommonSpirit hospitals in Colorado will go out-of-network Jan. 1, 2025. The contract split applies to Humana Medicare Advantage plans, according to a statement CommonSpirit shared with ...