The Arizona Department of Insurance and Financial Institutions has ordered RespondersHealth to cease and desist its insurance business in the state, as the company is unauthorized to sell health insurance. According to the Aug. 22 order, in early 2025, the…
The Latest
Federal and state regulators are turning up the heat, especially in Medicaid and Medicare Advantage. From heightened audit activity to stricter diagnosis coding rules, payers are under growing pressure to get documentation, chart reviews and claims submission right the first…
Oct 15, 2025 11:00 AM - 12:00 PM America/Chicago
Presented by:
Presenters
Cereasa Horner
Director of Policy and Payment Integrity, CERIS
Steven Hamilton
Partner, Crowell & Moring LLP
Payal Nanavati
Counsel, Crowell & Moring LLP
As a wave of insurers exit Medicare Advantage plans, Health Care Service Corporation is jumping in, launching plans in 948 counties across 30 states and the District of Columbia, according to a Sept. 10 news release. HCSC’s MA plans will…
Consulting groups and organizations are issuing their predictions for healthcare costs in 2026. And so far, they appear steep. Here is a roundup of what these groups are saying: Multiple surveys said employers are pointing to chronic and high-cost conditions,…
New Hampshire’s insurance commissioner is warning that some seniors in the state will have little to no access to Medicare Advantage in 2026 as insurers exit the market, the New Hampshire Union Leader reported Sept. 10. “From what I am…
Managed care organization Magellan Health, part of Centene, has appointed Steven Pratt, MD, as chief medical officer, according to a Sept. 10 news release. Dr. Pratt, a psychiatrist, will further the company’s clinical mission and engagement in his new role.…
Amid a wave of health systems dropping Medicare Advantage plans over administrative and reimbursement issues, the Medicare Payment Advisory Commission has found no “statistically significant change in hospital profit margins” due to growing enrollment in Medicare Advantage plans, according to…
An estimated 450,000 New Yorkers will lose zero-premium comprehensive health insurance amid the One Big Beautiful Bill Act’s cuts, according to a news release from the New York State Department of Health and a statement from Democratic Gov. Kathy Hochul.…
A federal judge in Minnesota has denied UnitedHealth Group’s request to narrow the scope of discovery in an ongoing lawsuit that accuses the insurer of using artificial intelligence to wrongfully deny Medicare Advantage members post-acute care. The case, filed in…
Hospitals are investing heavily in digital tools, but many still fail to realize meaningful ROI. Why? Because technology is rarely the limiting factor — the real challenges are resistance, complexity and misaligned workflows. In this virtual learning session, learn how…
Oct 22, 2025 12:00 PM - 1:00 PM America/Chicago
Presented by:
Presenters
Navaneeth Nair
Chief Product Officer, Infinx
Anthony Tedeschi, MD
former CEO, Tenet Healthcare Detroit
Stuart Newsome
Vice President RCM Insights, Infinx