Maryland has approved midyear rate increases for CareFirst BlueCross BlueShield and UnitedHealthcare in the state’s small group market, citing a significant rise in inpatient hospitalizations and inpatient and outpatient surgeries. The approved rates came in below what both carriers requested,…
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Centene’s ACA product in New Hampshire, Ambetter from NH Healthy Families, will discontinue coverage at the end of 2026. Provider agreements and member coverage will remain in effect until the end of the year, according to a June 26 update.…
Some CEOs may come and go. But David Cordani, the outgoing CEO of The Cigna Group, has been with the company for around 35 years, becoming president in 2008 and CEO in 2009. Mr. Cordani departs his role July 1…
Democratic governors and attorneys general from 25 states and Washington, D.C., sued the Trump administration June 29 over CMS’ interim final rule implementing Medicaid work requirements. Eight things to know: 1. The 74-page lawsuit, filed in U.S. District Court for…
Kansas Attorney General Kris Kobach filed a lawsuit in state court June 24 against Aetna, alleging the insurer misused tens of millions of dollars while administering the state employee health plan. Aetna has served as a third-party administrator since at…
Health plans are pouring resources into utilization and care management but the total cost of care keeps rising. During a recent webinar hosted by Becker’s Healthcare and ZS Associates, three health plan leaders and Vimbai Mudimu, associate principal at ZS…
When clinicians don’t trust clinical decision-support tools, they don’t just ignore them. They spend extra time verifying and correcting AI-generated recommendations undermining productivity and compromising the very quality-of-care gains these tools are meant to deliver. At Becker’s 16th Annual Meeting,…
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Montana is preparing to roll out its community engagement rules for Medicaid July 1, and Arkansas is soft-launching its requirements that same day. HR 1 outlined how low-income, nonpregnant adults ages 19 to 64 must work, perform community service or…
Federal prosecutors and auditors are targeting Medicaid behavioral health fraud on multiple fronts, with billions in alleged false claims under scrutiny nationally and two states alone facing audit findings of more than $123 million combined in potentially improper payments for…
Prior authorization reform is moving on multiple fronts in 2026 — through Congress, state capitals, federal courtrooms and the exam rooms where physicians spend an average of 13 hours per week on PA paperwork alone. Here are 10 recent updates…