Sens. Elizabeth Warren, D-Mass., and Josh Hawley, R-Mo., have introduced legislation that would prohibit companies from simultaneously owning a health insurer or pharmacy benefit manager and a medical provider or management services organization, and would require companies in violation to…
Author: Jakob Emerson
Humana lost $796 million in the fourth quarter of 2025, according to the company’s year-end earnings report published Feb. 11. The results reflect a higher medical loss ratio driven by a shift in business mix and the impact of the…
The House Judiciary Committee issued subpoenas Feb. 9 to eight health insurers, seeking documents about potential fraud issues related to ACA marketplace subsidies. The subpoenas target Blue Shield of California, Centene, CVS Health, Elevance Health, GuideWell, Health Care Service Corp.,…
The Cigna Group is cutting approximately 2,000 jobs globally by the end of February, representing less than 3% of its workforce. “As we drive greater efficiency across our business, we have made the difficult decision to reduce roles in our…
Oscar Health posted a $443 million net loss in 2025 after posting a $25 million profit the year before, as rising medical costs and higher risk adjustment transfers overwhelmed membership gains, according to its fourth quarter earnings report published Feb.…
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Montana has clawed back more than $23 million in fraudulent claims after PacificSource flagged more than 200 suspicious ACA enrollments tied to as much as $54.7 million in unjustified claims. A state investigation identified a scheme in which out-of-state individuals…
Alameda Alliance for Health, a county-organized Medicaid managed care plan serving more than 400,000 members in Alameda County, Calif., is bracing for a potential 40% to 45% reduction in membership over the next three years as federal Medicaid cuts and…
CMS released participation data Feb. 4 for Medicare accountable care organizations in 2026, showing continued growth in enrollment and a record number of beneficiaries served by the Shared Savings Program. Six things to know:
Elevance Health bid on 11 national accounts in competing Blue Cross Blue Shield markets last year and won nine of them, the company said on its 2025 earnings call with investors, offering the first look at how a landmark antitrust…
Molina Healthcare will exit the Medicare Advantage Part D business in 2027, the company announced alongside its fourth quarter and full year 2025 earnings report published Feb. 5. The MAPD product represents approximately $1 billion in annual premiums. Molina said…