CMS issued nearly $2.5 million in fines on Jan. 17 across multiple health plans for Medicare contract violations related to Part C maximum out-of-pocket limits and cost-sharing requirements, and Part ...

Payers are making strides in addressing disparities around mental health and substance use disorder care services but are still falling short of achieving parity under the Mental Health Parity and ...

Federal regulators questioned $8.47 million in charges from Florida Blue and its administration of the Federal Employees Health Benefits Program from 2018 to 2023. In audit findings published Jan. 8, ...

Insurers do not have to own every part of the healthcare system to improve connection, according to Jim Boyman, vice president of GuideWell Health. GuideWell is the parent company of Florida Blue. In ...

Blue Cross Blue Shield of Michigan is offering buyouts to employees as it targets hundreds of millions of dollars in administrative cuts, the Detroit Free Press reported Jan. 21. The Detroit-based ...

UnitedHealth Group reported record revenue in 2024, but profits declined as the company continues to grapple with costs associated with the February cyberattack on Change Healthcare and headwinds ...

Though Medicare Advantage beneficiaries are more likely to have coverage of vision, dental and hearing services, they are not more likely to use these services than their peers in traditional Medicare ...

Two relatively new insurers in the Medicare Advantage market saw spikes in enrollment for 2025 Clover Health, launched in 2014, grew its Medicare Advantage membership 27% year-over-year, according to ...

Solera Health has received $40 million in Series E financing, co-led by Health Care Service Corp., Cobalt Ventures, Horizon Mutual Holdings, and Adams Street. HCSC is the parent company of five BCBS ...

Centene's 'Ohana Health Plan has partnered with homeless services provider Hope Services Hawaii on a new residential program for integrated clinical care. The program will provide housing support for ...

Alignment Healthcare has promoted Dawn Maroney to president. Ms. Maroney was previously president of markets and CEO of Alignment Health Plan, according to a Jan. 13 news release. The Orange, ...

Payer executives are focused on staying adaptable in 2025. Becker's connected with 20 executives to learn how they are leveling up their leadership skills in 2025. Like what you see here? Join us at ...