The trustee overseeing litigation claims for bankrupt Dallas-based Steward Health Care System is suing five payers, alleging they owe the system’s former hospitals at least $56.9 million in unpaid claims. The trustee, Mark Kronfeld, filed the complaints Feb. 10 and…
Author: Madeline Scheetz
CMS unveiled a proposed rule Feb. 9 that would reshape the ACA marketplace for plan year 2027, expanding insurer flexibility on plan design, tightening eligibility verification, and re-introducing several program integrity measures that were blocked by a federal court last…
The board of directors for Orange, Calif.-based CalOptima Health has approved a $526.2 million investment to increase pay rates for hospitals, providers, community clinics, behavioral health providers, ancillary services providers and health networks.
From Kraft Heinz suing Aetna for alleged mismanagement of employee claims data to Elevance Health being sued by contracted labor unions for reportedly restricting claims data access, certain third-party health plan administrators are being forced to answer the big questions…
Cigna's Evernorth Care Group plans to cut specific specialty services and consolidate certain Arizona care locations in the next few months. The reductions will result in 261 employees being laid off, according to an Arizona WARN notice filed May 31.
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Medicare total spending hit $5.7 billion in 2022 for GLP-1 drugs such as Ozempic, Wegovy and Mounjaro, up from $57 million in 2018, according to a March 22 KFF analysis.
UnitedHealthcare and New York City-based Mount Sinai reached a multiyear contract agreement March 19, effective immediately, after a monthslong contract dispute.
Providence, R.I.-based Lifespan, the state's biggest health system, might not accept Cigna Healthcare insurance moving forward if an agreement over contract negotiations cannot be met by March 31.
The Justice Department has begun an antitrust investigation into UnitedHealth Group, The Wall Street Journal reported Feb. 27.
CalOptima, a Medicaid insurer in Orange County, Calif., terminated its contract with four hospitals owned by Ontario, Calif.-based Prime Healthcare on Feb. 5.