A federal jury in Florida has convicted an insurance brokerage president and the CEO of a marketing company for their roles in a scheme to fraudulently enroll individuals in subsidized ACA plans to obtain commission payments from insurers. The scheme…
Author: Jakob Emerson
Aetna is rolling out a generative AI-powered conversational assistant within its website and mobile app. The new tool synthesizes member benefits, provider networks and program information to deliver answers in plain language, eliminating the need for users to understand industry…
Molina Healthcare has been selected by the Florida Agency for Health Care Administration to administer a specialized Medicaid and CHIP program for low-income and underserved children. Molina was the sole plan selected and expects to serve approximately 120,000 enrollees of…
Blue Cross and Blue Shield of Massachusetts reported a year-to-date net loss of $101.4 million on revenue of $7.7 billion (-1.3% net margin) and expects to end the year with operating and net losses. The most recent financial results reflect…
CMS released 2026 premium and cost-sharing amounts for Medicare Parts A and B on Nov. 14, with significant increases across most categories. The standard monthly Part B premium will increase to $202.90, up $17.90 from $185 in 2025, or a…
Advertisement
MDwise is laying off 238 employees in January and will close its office in Indianapolis, according to regulatory documents filed Nov. 13. The layoffs follow Indiana’s decision to remove the insurer as a managed care health plan in its Medicaid…
Horizon Blue Cross Blue Shield of New Jersey has agreed to pay $100 million to settle allegations that it fraudulently induced the state to award it a multibillion-dollar contract to administer employee health benefits and then overcharged throughout the contract’s…
Optum Health, the care delivery arm of UnitedHealth Group, has named Krista Nelson as its new CEO. “I’m deeply grateful to be part of an organization with such an important mission and an incredible team,” Ms. Nelson wrote on Linkedin…
State insurance regulators are issuing warnings around what they describe as unfair practices by Medicare Advantage insurers to restrict enrollment. Amid rising costs and increased regulatory pressures, insurers have been adjusting their broker commission structures this year as many look…
UnitedHealth Group is working to position itself as a frontrunner in the wider healthcare industry’s ongoing technological transformation, with AI at the heart of its strategy to innovate, improve operational efficiency, and enhance the experience of its customers. As the…