A federal judge has lifted CMS’ freeze on new ACA marketplace broker registrations, clearing the way for approximately 19,000 licensed agents and brokers to assist consumers with 2027 coverage. The U.S. District Court for the District of Maryland ruled Nov.…
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Medicare Advantage insurer and healthcare technology company Clover Health appointed its interim CFO, Clay Thornton, to serve in a permanent capacity, according to a Nov. 4 U.S. Securities and Exchange Commission filing. Former CFO Peter Kuipers departed in March. According…
Payers are continuing to trim their workforces amid financial pressures, growing medical and pharmacy utilization, Medicaid funding cuts and strategic restructuring. Below are workforce reduction efforts or job eliminations that were announced or take effect in 2026. Insurance industry layoffs…
Oscar Health reported $167.3 million in profit for third-quarter 2026, compared to a net loss of $137.5 million in the same period last year. The company reported its third-quarter earnings Nov. 5. Oscar brought in $5.1 billion in revenue, a…
The Cigna Group’s total customer relationships declined 6% from Dec. 31, 2025, down to 177.6 million. Cigna reported its third-quarter earnings Nov. 5, attributing the decline in relationships to pharmacy and behavioral customers. Pharmacy and behavioral customers decreased 5% and…
A Des Plaines, Ill. man pleaded guilty to his role in a $227 million Medicare fraud scheme that billed the program for over-the-counter COVID-19 test kits beneficiaries never requested or received. Syed Kablazada, 36, pleaded guilty to two counts of…
Health systems have spent the past few years building the case for AI one use case at a time. Less clear is what AI will do to the nation’s healthcare bill. The question came up during the opening keynote at…
CMS has delayed by two years its plan to stop paying for remote patient monitoring services delivered by third-party vendor staff. The start date moves from Jan. 1, 2027, to Jan. 1, 2029, under the calendar year 2027 Medicare Physician…
Health insurer and hospital stocks climbed Nov. 4 after Democrats won majorities in both chambers of Congress in the Nov. 3 midterm elections, as analysts said the new Congress could delay Medicaid cuts and restore enhanced ACA subsidies. Here is…
HHS, the Labor Department and the Treasury Department are denying recertification for two independent dispute resolution entities — Island Peer Review Organization, known as IPRO, and Network Medical Review Company — according to a Nov. 4 update from CMS. Under…