As healthcare costs continue to rise, a growing number of employers are exploring alternative payment models such as direct contracting, where the employer contracts directly with a provider for employee care.
Author: Jakob Emerson
A California bill aimed at improving and enforcing the accuracy of insurer's provider directories has died in a state Senate committee.
Alabama's state employee health plan is facing a projected loss of about $20 million in fiscal year 2025, the Alabama Reflector reported Aug. 22.
A federal judge has ruled that Blue Cross and Blue Shield of Minnesota must face a lawsuit from the U.S. Labor Department accusing the payer of incorrectly imposing a state provider tax on self-funded health plan customers and violating its…
MMM Healthcare, a Puerto Rico subsidiary of Elevance Health, received $59 million in net Medicare Advantage overpayments for 2017, according to an audit from HHS' Office of Inspector General published Aug. 14.
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Carson City, Nev.-based Carson Tahoe Health has sent a final contract termination notice to UnitedHealthcare.
California has fined Anthem Blue Cross of California and its Medicaid subsidiary a total of $850,000 for illegally limiting coverage for gender dysphoria treatments.
CMS has approved Georgia's plan to transition to a state-based ACA exchange called Georgia Access.
A swirl of challenges is looming for Medicare recipients ahead of the annual enrollment period beginning Oct. 15.
In 2023, more than 61% of Ozempic prescriptions went to patients with commercial health insurance, and less than 10% of all semaglutide prescriptions went to Medicaid enrollees, according to a study published Aug. 2 in JAMA Health Forum.