Elevance Health is working to mitigate rising costs in its Medicaid business amid what executives describe as a challenging year ahead. The company reported its third-quarter earnings on Oct. 21, with senior leadership telling investors that escalating Medicaid costs, driven…
Author: Jakob Emerson
Point32Health, the parent company of Harvard Pilgrim Health Care and Tufts Health Plan, is laying off 254 employees in a second round of job cuts this year. In March, the company eliminated 110 positions to “reduce administrative costs as medical…
Monongalia County, West Virginia is dropping group coverage from Highmark Blue Cross Blue Shield in favor of Individual Coverage Health Reimbursement Arrangements administered by Take Command, local outlet WAJR reported Oct. 20. Premiums will continue to be almost entirely covered…
California Attorney General Rob Bonta has reached a $34 million settlement to resolve claims that the Aliera Companies and its subsidiaries, along with Sharity Ministries, (formerly Trinity Healthshare) sold and operated sham health plans in violation of state law. The…
Wellmark Blue Cross and Blue Shield has filed a lawsuit against Iowa’s insurance commissioner, challenging the enforcement of a newly enacted state law that regulates pharmacy benefit managers and the administration of prescription drug benefits. The lawsuit, filed on Oct.…
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CMS Administrator Mehmet Oz, MD, discussed some of the biggest issues facing the Medicare Advantage program at an Oct. 15 industry conference. During his first six months on the job, CMS has already overseen policy moves to streamline prior authorization…
Commercial insurance prices were 78% higher in hospital outpatient settings compared with ambulatory surgical centers in 2024, according to a Health Affairs study published in October. The analysis, led by researchers at Brown University, examined 2024 pricing data for UnitedHealthcare,…
Blue Shield of California is conducting a third round of layoffs this year, with 150 more employees being laid off in December. The nonprofit insurer laid off 138 employees in September and 113 employees in May. The majority of the…
The Medicare open enrollment period runs from October 15 to December 7, setting insurers’ 2026 membership and revenue trajectories as beneficiaries select Medicare Advantage and Part D coverage. The 2026 cycle is unfolding amid a projected MA enrollment decline, lower…
Michigan Gov. Gretchen Whitmer signed legislation Oct. 7 that aims to preserve the state’s Medicaid funding by maintaining its Insurance Provider Assessment tax. The new law instructs the state to request a waiver from CMS to continue the tax on…