A man charged in connection with one of the largest Medicare fraud schemes in U.S. history is back in American custody after being apprehended in Northern Cyprus and flown to South Florida, the Justice Department said June 23. Ibrahim Khaldoon…
The Latest
It’s not every day the country’s largest healthcare company provides on-the-record access to its senior leadership team, no topics barred. But that is exactly what UnitedHealth Group has done, inviting reporters and social media influencers to its corporate headquarters in…
Rising complexity, limited resources: How health plans can close the clinical expertise gap
Sponsored
Health plans are facing a convergence of pressures unlike anything in recent memory. Clinical cases are growing more complex as people suffer from more chronic conditions. Regulatory expectations continue to rise. Finances are under constant scrutiny. And through all of…
Unprecedented growth creates unprecedented complexity. As Ochsner Health expanded to 47 hospitals across the Gulf South, medical device spend climbed 141% between 2018 and 2024 — and a growing share of procedural spend remained invisible to the teams managing it.…
Presented by:
In April, President Donald Trump nominated Erica Schwartz, MD, to serve as CDC director. On June 16, she outlined steps to cut ties with her employer, UnitedHealth Group. As recently as May 2025, Dr. Schwartz served as UnitedHealthcare’s president of…
The White House Council of Economic Advisers addressed the possibility of banning antisteering practices, which prohibit insurers from guiding patients to lower-cost providers, in payer-provider contracting. Its conclusion: Prices and premiums could drop. Along with broader antisteering issues, the memo…
CareFirst BlueCross BlueShield has filed a federal racketeering lawsuit against a Maryland insurance broker and his brother, alleging the pair fraudulently enrolled overseas clients in health plans meant for Maryland residents as part of a yearslong scheme that cost the…
A Pennsylvania bill would create a category of aggravated assault in the state’s criminal code to hold health insurer CEOs liable if a covered person gets an “adverse benefit determination” of a medically necessary benefit that leads to serious bodily…
James Polo, MD, will serve as chief medical officer for Optum Behavioral Health, according to a June 22 LinkedIn post. In his role, Dr. Polo focuses on clinical quality and policy, member experience, regulatory strategy, utilization management, affordability, innovation, and…
Smokers. Diabetic patients. Revision cases. Multilevel fusions. These are the patients where reliable fusion is hardest to achieve and where biologic selection carries the most weight. A clinical evidence review brings together more than 10 years of published literature and…
Presented by:
