Author: Jakob Emerson

CMS uses star ratings to determine the quality of Medicare Advantage prescription drug plans. The agency may terminate a plan sponsor's contract to administer Medicare benefits if it achieves a rating of less than three stars for three consecutive contract…

The Pennsylvania Insurance Department has launched an online independent appeal process for state residents who believe their health plan wrongly denied a medical claim.

The Cigna Group is getting ready to launch a new program that offers employers and health plan sponsors a way to manage obesity, diabetes and cardiovascular disease using weight loss drugs, or GLP-1s.

UnitedHealth Group is the world's largest insurance company by net premiums for the ninth year in a row, according to AM Best's annual ranking of global insurers published in January. 

Editor's Note: Under a new multi-year agreement, physicians of Baptist Health Medical Group will be in-network for Humana's Medicare Advantage members and commercial group accounts beginning April 1, 2024. 

CMS is terminating Chicago-based Zing Health's Medicare Advantage prescription drug plan at the end of 2024 following three consecutive years of star ratings below three stars.

Virginia has banned payers offering coverage on the ACA marketplace from including a surcharge for tobacco use, effective Jan. 1.

Managed Medicaid and Medicare Advantage insurers economically lagged behind other payers and the wider market in 2023, according to a Jan. 5 analysis from S&P Global Market Intelligence.

The California Department of Managed Health fined Anthem Blue Cross of California $690,000 for failure to reimburse providers and members in a timely manner during the second half of 2021. 

Elevance Health and its insurance subsidiaries are suing HHS for "unlawful, and arbitrary and capricious" methodology changes to how Medicare Advantage and Part D star ratings are calculated.