CMS has fined 13 health plans a combined $1.5 million for Medicare Advantage program violations spanning cost-sharing rules and Part D drug benefit administration. The penalties, issued May 1, stem largely from claims processing system errors that caused enrollees to…
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Hospitals are confronting a new and unexpected pressure point in 2026: Fewer patients losing coverage are transitioning to Medicaid. The slowdown, emerging alongside ACA exchange attrition, is adding to uninsured volumes and complicating payer mix assumptions for some of the…
Nearly three-quarters of physicians say they’re satisfied with their jobs. But fewer than two-thirds plan to stay — and less than 1 in 3 would recommend their organization to a colleague. That gap is a financial and operational risk. CHG…
Jun 16, 2026 11:00 AM - 12:00 PM CDT
Presented by:
Presenter:
- Austin Chatlin
Massachusetts Attorney General Andrea Joy Campbell has settled with Adroit Health Group for $5 million over allegations the Texas-based insurer misled thousands of consumers about the health coverage it sold them beginning in 2016. The attorney general’s office alleged that…
Heather Cianfrocco has been named COO of Pittsburgh-based Highmark Health, effective immediately, according to a May 5 news release. Prior to her new role, Ms. Cianfrocco served as executive vice president of governance, compliance and information security for UnitedHealth Group. She has…
Eighty-four percent of health plan leaders believe Medicaid eligibility checks could cause, at minimum, moderate disruption in maternal care continuity, according to a May 5 report from healthcare consultancy Sage Growth Partners. Within that group, 14% expect major disruption. The…
Montana State Auditor and Commissioner of Insurance James Brown said his office is taking action against Strategic Limited Partners, according to a May 4 news release. Some consumers were under the impression that SLP offered ACA-approved plans. On April 1,…
Fort Lauderdale, Fla.-based Broward Health filed a lawsuit against Florida Blue and its HMO due to alleged underpayments for emergency department services, according to an April 7 state court complaint. Broward Health has been out of network for Florida Blue…
The California Hospital Association has filed a lawsuit against Anthem Blue Cross over a policy that would penalize hospitals when patients receive care from out-of-network physicians, even if the hospital is in network. The lawsuit, filed May 4 in Sacramento,…
UnitedHealthcare is paring down prior authorizations for 30% of applicable services, according to a May 5 news release. The cuts will take place by the end of 2026, with the insurer rolling back requirements for some outpatient surgeries, diagnostic tests…