A federal judge ruled that Florida failed to provide adequate notice to Medicaid recipients before terminating their coverage during the post-pandemic unwinding process. The class-action lawsuit was filed in August 2023, alleging that beneficiaries received confusing notices from the state’s…
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The United Health Foundation’s 2025 “America’s Health Rankings Annual Report,” published Jan. 8, presented a wave of optimistic health signals, but disparities persist. The organization analyzed 99 measures from 31 sources, relying on the most recent data, as of Oct.…
A report from the Office of the New York State Comptroller published Jan. 6 found Anthem Blue Cross either did not recover or remit over $19.3 million in hospital claim overpayments and relied on incorrect time periods to evaluate the…
Wisconsin’s Medicaid program is projecting a $213.2 million shortfall through fiscal year 2027, driven largely by higher-than-expected enrollment in long-term managed care programs, according to a Jan. 5 report from the state Department of Health Services. The projected deficit, which…
Anthem Blue Cross is suing 11 Prime Healthcare hospitals in California, accusing them of defrauding the insurer by “knowingly flooding” the No Surprises Act’s independent dispute resolution process with thousands of claims they knew were ineligible for arbitration. The complaint,…
The Council for Affordable Quality Healthcare is transitioning away from its nonprofit structure, sharing how the country’s biggest health insurance companies are now serving as owners, according to a Jan. 6 news release. CAQH was originally founded by a coalition…
Nearly two-thirds of healthcare leaders say their IT infrastructure is not prepared to manage future risk. As AI investments rise, foundational readiness gaps are becoming harder and more costly to ignore. Drawing on a global survey of healthcare executives and…
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Laws in North Dakota, Nebraska and Alaska focused on accelerating insurer response times for prior authorizations went into effect Jan. 1. North Dakota Gov. Kelly Armstrong signed the state’s bill in April. The legislation requires plans to decide on nonurgent…
Premera Blue Cross is expanding its case management resources for cancer care, according to a Jan. 6 news release. The patient navigation program, called Premera Cancer Support, relies on a partnership with Thyme Care, an oncology startup that focuses on…
HHS has finalized updated cervical cancer screening guidelines that will require most health insurers to cover self-collection testing and additional screening procedures beginning in 2027. The guidelines were published by the Health Resources and Services Administration on Jan. 5 and…