Author: Rylee Wilson

2023 was an eventful year for Medicare Advantage. 

In 2023, Aetna, like many other payers, laid off employees. The insurer also snagged a big contract in North Carolina, and had another multibillion dollar contract blocked in New York City. 

Several payers named new top leaders in 2023. Notable transitions include Envision Healthcare CEO Jim Rechtin's appointment as Humana's next CEO and former Aetna CEO Mark Bertolini's appointment as CEO of Oscar Health. 

The Justice Department wants Humana's lawsuit challenging a CMS rule that would implement stricter auditing standards on Medicare Advantage plans moved to a different court, then thrown out. 

Humana is the latest insurer facing a lawsuit over allegedly using automated tools to deny Medicare Advantage members' claims, and Molina expects its acquisition of Bright Health's Medicare Advantage business to close soon. 

HHS is urging states to do more to prevent eligible children from being disenrolled from Medicaid coverage. 

Molina Healthcare reduced its offer for Bright Health's California Medicare Advantage business. 

California's managed healthcare department fined Blue Shield of California $200,000 for mishandling provider claims. 

The Federation of American Hospitals is asking CMS to include how often Medicare Advantage carriers uphold or overturn initially denied prior authorization requests into how the agency calculates star ratings for the program. 

Health Care Service Corp. and Elevance Health are vying for Cigna's Medicare Advantage business, Bloomberg reported Dec. 15.