Summa Health will no longer schedule appointments for people with out-of-network and non-contracted insurance plans, effective Sept. 1. The policy includes services provided by the system’s medical group, walk-in services at its urgent care centers, and laboratory and radiology services.…
Author: Jakob Emerson
A federal judge has paused portions of a new ACA rule that were set to take effect on Aug. 25, which included stricter eligibility verifications and limitations on premium subsidies. “Eliminating coverage for an estimated 1.8 million people will drive…
Troy Health, a North Carolina-based Medicare Advantage insurer, has entered into a non-prosecution agreement with the Department of Justice after admitting to a scheme involving fraudulent Medicare enrollments and identity theft. The company used automation and artificial intelligence software to…
Pittsburgh-based Highmark Health reported $16.5 billion in revenue, $121 million in operating income and $329 million in net income in the first half of 2025. “Strong first half performances by AHN and United Concordia Dental were offset by continued pressure…
Oscar Health is teaming up with grocery chain Hy-Vee to offer a new employer health benefits plan in Des Moines, Iowa. If approved by regulators, the partnership will use an Individual Coverage Health Reimbursement Arrangement (ICHRA) model, which allows employers…
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As some federal lawmakers shed millions in UnitedHealth stock amid investigations and financial turmoil, Warren Buffett’s Berkshire Hathaway is betting big on the embattled healthcare conglomerate. Lawmakers from both parties sold as much as $1.2 million in UnitedHealth stock against…
Cambia Health Solutions and Blue Cross Blue Shield of North Dakota plan to enter a strategic affiliation that would bring the Fargo-based insurer under Cambia’s management while maintaining its local governance and mutual status. The agreement would integrate BCBSND into…
Elevance Health has partnered with the National Association of Community Health Centers to integrate food as medicine initiatives into primary care services for Medicaid members at Community Health Centers. Elevance will train CHC primary care teams to identify and support…
Independent Health is cutting 59 jobs across multiple departments, effective immediately, the Buffalo News reported Aug. 20. Independent Health has about 1,200 employees, 340,000 members and reported a net loss of $66 million in 2024. “Like health plans nationwide, we…
The U.S. Office of Personnel Management will end coverage of gender transition-related surgeries and hormone treatments under the Federal Employees Health Benefits and Postal Service Health Benefits programs, beginning in 2026. In an Aug. 15 letter to carriers, OPM said…