Twelve Democratic senators signed a March 19 letter detailing their plan for health insurance reforms. The letter said Senate Finance Committee Democratic staff will design policies to elevate affordability, break down barriers to accessing insurance and rein in insurance companies.…
Author: Elizabeth Casolo
At least nine state-run marketplaces have seen a correlation between skyrocketing ACA premiums and enrollees downgrading to bronze plans, according to a March 9 analysis by Healthinsurance.org. The organization is a privately-run website that offers health insurance educational resources for…
In the wake of Washington, D.C.-based Risant Health’s acquisition of Danville, Pa.-based Geisinger Health, the organizations are requesting reduced capital requirements for Geisinger’s insurance business, according to a Jan. 16 filing with the Pennsylvania Insurance Department. Risant is a nonprofit…
Jersey City, N.J., Mayor James Solomon has hired an auditor to review health insurance claims paid by Horizon BCBS New Jersey, according to a March 17 news release. Horizon previously served as the city’s third-party health insurance administrator. The insurer…
HSS’ Office of Inspector General estimates that BCBS Alabama received at least $7 million in Medicare Advantage overpayments, according to a March audit report. From a sample of 271 enrollee-years, 247 had medical records that did not align with diagnosis…
Advertisement
The Trump administration is widening its Medicaid fraud crackdown to Florida, with CMS sending a letter March 17 to Gov. Ron DeSantis and other state leaders that requests information on how the state identifies, prevents and addresses Medicaid program integrity…
BCBS Kansas City and Highmark earned regulatory approval from the Missouri Department of Commerce and Insurance to close their affiliation deal, according to a March 17 news release. Their affiliation will close March 31. However, the companies said integration will…
The Association for Community Affiliated Plans, Alliance of Community Health Plans, America’s Essential Hospitals, AHIP and the Federation of American Hospitals are asking CMS to pull back on its proposal to permit non-network plans to receive qualified health plan certification,…
As of February, a share of payers and providers had not yet started working toward the application programming interface requirements established by CMS’ interoperability and prior authorization final rule, according to survey results released March 10 by the Workgroup for…
BCBS Rhode Island posted a $10 million operating loss in 2025, the insurer shared March 12. The company had a normalized operating loss of $78 million, a -3.2% margin, up from $115 million in 2024, where it recorded a -5.2%…