CMS will audit every Medicare Advantage plan for potential overpayments annually, in what the agency called an “aggressive” plan to step up oversight. According to a May 21 news release, the agency plans to audit each of the more than…
Author: Rylee Wilson
Florida would see the largest increase in its uninsured population if ACA premium tax credits are not extended, and Medicaid work requirements and other changes are implemented, according to KFF. Lawmakers are considering a reconciliation package that would implement Medicaid…
Evernorth, the Cigna Group’s health services arm, will cap out-of-pocket costs for Zepbound and Wegovy, two GLP-1 drugs, at $200. Members can save up to $3,600 a year compared to purchasing the drugs directly or through consumer programs, according to…
AI, digital health and value-based care are among the biggest buzzwords in healthcare — and might be overhyped, according to these payer executives. Becker’s connected with 11 leaders to learn what’s overhyped in healthcare. Like what you see here? Join…
CMS cannot track whether states are repaying the federal government the correct share of funds Medicaid managed care plans do not spend on beneficiary care, according to an audit HHS Office of Inspector General published May 16. Many states require…
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UnitedHealth Group is asking shareholders to support a $60 million stock option award for its new CEO. In a May 20 letter to shareholders, Christopher Zaetta, UnitedHealth’s chief legal officer, urged shareholders to approve the company’s executive compensation. Institutional Shareholder…
Centene subsidiary Superior Health Plan’s use of private investigators did not violate any laws, an investigation by Texas’s Attorney General’s Office found. In March, Texas Attorney General Ken Paxton launched an investigation into Superior Health Plan, after former CEO Mark…
A federal judge has ruled against Florida Blue, deciding the insurer is not entitled to have its Medicare Advantage star ratings reevaluated. In December, attorneys for Florida Blue filed a lawsuit in federal district court in Washington, arguing CMS did…
Horizon Blue Cross Blue Shield will pay New Jersey $1.25 billion over 18 years from its conversion to a nonprofit mutual holding company— but where these funds should go has sparked debate, NJ Spotlight News reported May 19. In 2022,…
A group of lawmakers is urging a federal court to allow a lawsuit alleging UnitedHealth Group overcharged the federal government for Medicare Advantage claims to continue. Led by Washington Rep. Pramila Jayapal, 29 U.S. representatives signed on to an amicus…