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Providence Health Plan recorded a $102 million net loss in 2025, driven by rising medical and pharmacy utilization and a…
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UnitedHealth Group reported only 10 subsidiaries in its U.S. Securities and Exchange Commission filings for 2025, down from thousands in 2024. UnitedHealth has expanded greatly over the last decade. For example, in 2022, UnitedHealth overcame federal antitrust concerns and was…
Clover Health said it is the first health insurer to be live on a CMS-aligned network for patient-directed requests, according to a March 4 news release from the company. While CMS previously listed other payers as “early adopters” of CMS-aligned…
In recent months, payers across the country have tried tightening policies to get a better grip on evaluation/management coding. While payers often say the policies aim to control costs or combat fraud, these more restrictive policies are often met with…
Network Health, a Wisconsin-based insurer owned by Froedtert ThedaCare Health, grew 37% during this past annual enrollment period to 126,000 total Medicare Advantage members, its second consecutive year of record growth. The plan also posted a 98% member retention rate.…
Health Alliance Plan promoted Chris Moyer to senior vice president of markets, broadening his role as president of ASR Health Benefits, a subsidiary and third-party administrator for employer health plans. According to a March 4 news release from HAP, which…
Anthem and New York City-based Mount Sinai are completely out of network as of March 4, following a brief contract extension for facilities, both organizations confirmed. Negotiations began in spring 2025. The contract expired Dec. 31, 2025, resulting in 9,000…
Payers have faced state penalties in 2026 for slow reimbursements, mishandled member complaints, and mental health parity violations. Fines in 2025 are here. Payers fined by states in 2026: 1. Aetna was fined $550,000 by Pennsylvania in March following a…
Blue Cross Blue Shield of Wyoming President and CEO Diane Gore will retire after 40 years with the organization, the company said March 4. Ms. Gore is the fifth CEO in the company’s 80-year history, first joining BCBSWY in her…
Minnesota filed a lawsuit against CMS and HHS, as well as their respective leaders, Mehmet Oz, MD, and Robert F. Kennedy Jr., regarding $243.8 million in deferred Medicaid funds, according to March 2 documents filed through the U.S. District Court…
Medicare Advantage plans looking to maintain no-premium models could face 50% cuts to supplemental benefits and $1,000 more in older adults’ cost exposure in 2027, according to February reports commissioned by health insurance trade association AHIP. Wakely Consulting Group conducted…
