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Ten states have still not expanded Medicaid under the ACA. If those states were to move toward expansion, 2.3 million…
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UnitedHealthcare and AARP are facing a lawsuit regarding alleged Medicare supplement denials, according to a Feb. 22 complaint filed with the U.S. District Court for New Jersey. The organizations collaborate on a handful of AARP-branded insurance products, including Medigap plans.…
The Iowa House passed legislation on Feb. 25 that would ban health insurers from denying coverage for a service solely because the referring primary care provider is out of network. Under the legislation, insurers would also be barred from imposing…
The Office of the Inspector General for HHS found 121,454 emergency department procedures were possibly billed incorrectly in 2021 and 2022, leading to over $15.1 million in improper or potentially improper payments. Medicare improperly paid physicians $922,524 and may have…
Payers are continuing to trim their workforces amid financial pressures, growing medical and pharmacy utilization, Medicaid funding cuts and strategic restructuring. Below are workforce reduction efforts or job eliminations that were announced or take effect in 2026. Insurance industry layoffs…
The Congressional Joint Economic Committee identified an additional $13.4 billion contributing to higher Medicare Part B premiums in 2025 due to Medicare Advantage overpayments, according to a March 10 report. The committee relied on Medicare Payment Advisory Commission estimates. Overpayments…
The possibility of a state-based health insurance exchange in Mississippi is looking less probable, state Insurance Commissioner Mike Chaney told Mississippi Today in a March 10 report. “It might be too little, too late, because the dollars are not there…
Idaho Republican state lawmakers have introduced a bill to repeal Medicaid expansion, the Idaho Capital Sun reported March 9. Four things to know: 1. The proposed legislation would repeal Medicaid expansion on Jan. 1, 2028, removing about 90,000 Idaho residents…
On March 8, a judge for the U.S. District Court in Connecticut approved a preliminary injunction against Aetna, ordering the insurer to alter its gender-affirming care policy for two plaintiffs. Several transgender women sued Aetna in 2024 over denied gender-affirming…
Anthem Blue Cross of California is bringing its controversial out-of-network penalty policy to California on June 1, a move that has already drawn legislative backlash in the insurer’s home state of Indiana. Under the policy, participating hospitals and facilities in…
Spartanburg (S.C.) Regional Healthcare System is slated to go out of network with Aetna commercial and Medicare Advantage plans April 15, according to the system’s website. The health system said its misalignment with the insurer stems from their Medicare contract,…
