Two Aetna employees were arrested for allegedly orchestrating a $1.1 million fraud scheme, according to a Nov. 15 news release from Florida CFO Jimmy Patronis. According to the release, Rochell Green ...

The 2025 Medicare Advantage market is seeing major changes, with some insurers expanding into new counties and others exiting certain counties. In total, 18 major insurers exited some Medicare ...

The CEOs of at least three payers plan to retire at the end of 2024. Here are five executive retirements Becker's has reported this year: Centene president Ken Fasola plans to retire in July 2025. Mr.

Blue Cross and Blue Shield of Massachusetts reported a $114 million operating loss in the first nine months of the year, partly due to skyrocketing claims for GLP-1 medications. 1. BCBSMA reported an ...

Fast-paced advancements in generative AI will change the core operations of every healthcare organization. AI-driven technology is not just a side project anymore. AI solutions including generative AI ...

WPS Health Solutions is laying off 313 employees in Wisconsin due to competitive pressures and federal contract losses. The layoffs will begin to take place in Monona and Madison on January 21, 2025, ...

California has the highest number of individuals with Medicare Part D coverage, while Washington, D.C. has the lowest amount, according to KFF. The 2024 data from CMS includes standalone Part D and MA ...

Fewer Medicare Advantage insurers will offer remote access technologies and over-the-counter benefits in 2025 than in 2024, according to an analysis from KFF. In a report published Nov. 15, the health ...

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Editor's note: This story was updated Nov. 15 to reflect Huntsville Hospital Health System reached a new contract agreement with UnitedHealthcare. Huntsville (Ala.) Hospital Health System reached a ...

Minnesota's Attorney General has reached a settlement with Blue Cross and Blue Shield of Minnesota regarding accessibility of mental health services. In June 2019, the Minnesota Attorney General’s ...

Payer executives expressed confidence in the continuation of enhanced subsidies in some form past 2025. Enhanced subsidies, which help individuals with incomes up to 400% above the federal poverty ...