Federal employees will soon need to verify the eligibility of any dependent they add to their health plan under a new rule finalized by the Office of Personnel Management. The rule, published June 2, implements the FEHB Protection Act of…
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University of California Health and Cigna Healthcare have so far been unable to reach a new network contract agreement ahead of a July 1 deadline. The potential split would affect UC Health hospitals, facilities and providers across the state, including…
CMS has issued more than two dozen fines against Medicare Advantage, Part D and special needs plans since January 2025, largely because of inadequate benefits administration or claims processing errors that caused enrollees to overpay for medical services and prescription…
Two health plan vendors providing in-home and mobile health services, along with the founder of one of the firms, have agreed to pay a combined $56.5 million to resolve federal allegations that they submitted false diagnosis codes to inflate Medicare…
HHS Inspector General T. March Bell said Hawaii’s Medicaid fraud control unit is no longer certified — and has lost reimbursements from the federal government, as a result. In a June 4 letter to Hawaii officials, Mr. Bell called out…
CMS on June 1 published the interim final rule outlining how states will carry out Medicaid work requirements. The rule sets the operational framework for a policy hospitals warn will push eligible patients off coverage and drive up uncompensated care.…
John Quinlivan, CEO of financially challenged Montgomery, Ala.-based Jackson Hospital, has warned of imminent closure unless BCBS Alabama agrees to raise reimbursement rates to match Baptist Medical Center South, located three miles away. “We filed a brief in our bankruptcy…
St. Louis-based Ascension has completed its acquisition of ambulatory surgery center operator AmSurg, expanding its footprint to 300 ASCs nationwide. The deal, valued at about $3.9 billion, marks a significant step in Ascension’s strategy to expand outpatient services and respond…
In Minnesota’s review of 5,583 “high-risk” Medicaid providers, 2,061 were revalidated, but 3,411 were notified of their disenrollment. A state report confirmed Minnesota completed its revalidation by May 31. The review removed 111 providers who were no longer offering high-risk…
Alvaro Molina will serve as interim South Florida market president for Florida Blue, effective June 12. Mr. Molina, currently the Miami market leader, is taking over as David Wagner retires, according to a May 28 news release. Mr. Molina has…