Author: Rylee Wilson

Medicare Advantage plans received $50 billion in payments between 2018 and 2021 for "questionable diagnoses" insurers added to medical records, a Wall Street Journal investigation published July 8 has found. 

Forty organizations received revised star ratings from CMS after the agency recalculated its star ratings for 2024. 

A federal judge has paused implementation of CMS regulations capping the amount Medicare Advantage companies can pay brokers that sell their plans. 

HHS' Office of Inspector General will audit Medicare Advantage plans' use of prior authorization in post-acute care settings. 

CMS has approved requests from five states to provide Medicaid coverage to incarcerated people before they are released. 

A group of 24 lawmakers expressed concern Express Scripts could be limiting Tricare beneficiaries' choice of pharmacies. 

Seven additional Medicare Advantage contracts picked up five-star ratings from CMS after the agency recalculated its ratings for 2024. 

AmeriHealth Caritas has laid off 102 employees, the Philadelphia Inquirer reported July 2. 

Sentara Health Plans and Virginia Children's Care Network are launching a value-based partnership to improve outcomes and lower costs for children enrolled in Medicaid. 

Independence Blue Cross has named two new vice presidents.