Author: Jakob Emerson

CMS has lifted an enrollment sanction imposed on PACE Partners of Northeast Florida, effective Aug. 6.  The enrollment suspension came after more than a year of regulatory action following compliance deficiencies identified during audits conducted in 2021, 2022 and 2023.…

UnitedHealth Group and Amedisys have reached a proposed final agreement with the Justice Department and attorneys general in four states to resolve an antitrust lawsuit that had temporarily halted their proposed $3.3 billion merger.  On Aug. 7, the U.S. District…

In 2025, Aetna offers the best desktop digital experience among major insurers, and Anthem BCBS plans offer the best mobile app experience, according to new research from Corporate Insight shared with Becker’s. Corporate Insight’s “2025 Commercial Health Plan Experience Benchmark,”…

Arkansas Gov. Sarah Huckabee Sanders is calling on the state’s insurance commissioner to reject proposed individual ACA rates filed by Centene and Arkansas Blue Cross Blue Shield. Centene’s QCA Health Plan requested a 54% rate increase, and BCBS’ HMO plan…

UnitedHealthcare has named Krishna Ramachandran as CIO for operations and experience. “We are living through a pivotal moment in human history and evolution, with advancements in technology, data, and artificial intelligence changing our world at a rapid pace,” Mr. Ramachandran…

Blue Shield of California has partnered with Gemini Health to launch “Price Check My Rx,” a new tool that sends mobile alerts to prompt members to review drug prices and compare lower-cost alternatives through the insurer’s app. Blue Shield says…

Oscar Health reported a net loss of $228 million in the second quarter of 2025, compared to $56 million in net income during the same quarter last year, according to its Aug. 6 financial report.  “Oscar is well-positioned to manage…

Aetna is rolling out a new inpatient reimbursement policy for its Medicare Advantage and Special Needs Plans, effective Nov. 15. “Our goal is simple: We want to help you get reimbursed faster for inpatient admissions that are initially denied. You’ll…

Major insurers are retrenching their Medicare Advantage strategies as federal cost‑containment measures and rising medical expenses squeeze profitability. Amid the growing financial pressures the industry has faced for nearly two years, the largest MA carriers are cutting supplemental benefits, exiting…

In June, Cigna began launching a suite of new AI tools designed to help members better navigate their health benefits.  The new features are being rolled out in phases on Cigna’s member portal, where enrollees will have access to an…