HHS is appealing a judgment that vacated CMS’ Medicare Advantage Risk Adjustment Data Validation program final rule, according to a Nov. 21 filing in the U.S. District Court for the Northern District of Texas. The 2023 final rule allowed CMS…
Author: Elizabeth Casolo
“Affiliation” is a buzzword in insurer partnerships. It may seem ambiguous, but this is a standard term for nonprofit M&A-type activity. A CareSource spokesperson told Becker’s that the nonprofit does not always use the term “acquisition,” instead calling an agreement…
A Medicare tool for adjusting risk underpredicts mortality and overpredicts spending for rural beneficiaries, according to research from the Philadelphia-based Leonard Davis Institute of Health Economics at the University of Pennsylvania. The study, published in the September 2025 issue of…
Blue Cross and Blue Shield of Minnesota will no longer offer gym memberships for Medicare beneficiaries at YMCA of the North and at Life Time, as of Jan. 1, both gym operators and the insurer confirmed to Becker’s. About 26,000…
Nearly 70% of Medicaid enrollees diagnosed with an opioid use disorder did not receive appropriate medications — such as buprenorphine, methadone or naltrexone — within 180 days of diagnosis, according to a study published Nov. 23 in The American Journal…
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Legally residing refugees and asylees will face new challenges with accessing health insurance coverage. The 2025 budget law will cut Medicaid spending by about $1 trillion over 10 years, and Medicaid data usage by Immigration and Customs Enforcement is slated…
Medicaid information sharing with Immigration and Customs Enforcement officials will pick back up shortly, according to a Nov. 21 CMS notice. “This notice announces CMS policy that CMS will provide certain information to ICE upon request from ICE consistent with…
Jenny Smith is the Hawaii Medical Service Association’s new COO and first female president. Her priorities as the organization’s operational lead are not overly fancy, but she does not think that makes them any less important. “If we do not…
California patients are suing Blue Shield of California and Magellan Health over alleged inaccurate mental health provider directories, according to a class-action lawsuit filed Nov. 19. The lawsuit said Blue Shield of California and Magellan work together to administer behavioral…
AHIP published its state-by-state report on health coverage Nov. 12, which includes the average salary for health insurance industry employees across the U.S. Calculations for the average salaries are based on U.S. Census Bureau data from 2022. The District of…