CMS has formally terminated UCare’s Medicare Advantage contracts after the insurer declined to sign agreements for 2026. The move impacts about 158,000 MA members in Minnesota and western Wisconsin, where UCare is the second-largest MA carrier with 26% market share.…
Author: Jakob Emerson
A federal judge has granted preliminary approval to Elevance Health’s $12.9 million settlement resolving a class action lawsuit that accused the insurer of improperly denying coverage for residential treatment of mental health and substance use disorders. The lawsuit was originally…
Dan Kueter is the CEO of UnitedHealthcare’s employer and individual insurance business, an $80 billion division and the nation’s largest company that offers health coverage to employers nationwide. Mr. Kueter has been with the company since 2001 and has served…
In one of the largest shifts in the Medicare Advantage landscape in recent years, Health Care Service Corporation has nearly quadrupled its Medicare Advantage membership after closing on a $3.3 billion acquisition of Cigna’s Medicare business in March. The deal,…
Aetna is expanding a program that aims to reduce readmissions for its Medicare Advantage members to ten hospitals by the end of 2025. The insurer is currently implementing the clinical collaboration program at Merriam, Kan.-based AdventHealth Shawnee Mission, Houston Methodist,…
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The National Committee for Quality Assurance has once again named the highest-quality and most effective health plans in the country, with Blue Cross Blue Shield of Massachusetts remaining at the top. On Sept. 16, the NCQA released its 2025 ratings…
CMS has finalized a rule requiring Medicare Advantage plans to submit provider directory data for inclusion in the Medicare Plan Finder. The change, aimed at improving transparency and beneficiary decision-making, takes effect January 1, 2026. Under the rule, MA plans…
Elevance Health is expanding its education and professional development benefits with new programs centered on artificial intelligence and career growth. The insurer is partnering with OpenAI to offer employees AI certifications, including training in areas such as prompt engineering and…
The Department of Justice has filed a False Claims Act lawsuit against Inland Empire Health Plan (IEHP), alleging the Rancho Cucamonga, Calif.-based insurer misused federal Medicaid expansion funds and submitted false statements to the state. The Sept. 17 complaint was…
Health insurers say they will continue to provide coverage for recommended immunizations without cost-sharing through 2026. “Health plans are committed to maintaining and ensuring affordable access to vaccines,” AHIP said Sept. 16. “Coverage decisions for immunizations are grounded in ongoing,…