The House of Representatives voted to extend the ACA enhanced tax credits that expired at the end of 2025 for three years. The measure now heads to the Senate. The 230-196 vote followed a Democrat-led discharge petition that reached the…
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As Medicaid eligibility fluctuates, Medicare reimbursement tightens and coverage rules evolve, health systems are seeing more denials, underpayments and avoidable write-offs rooted in front-end gaps. Health systems that fail to adapt risk compounding denials, underpayments and avoidable write-offs in 2026.…
Presented by:
Presenters
Joanna Caballero, MHA, CCS, CRC, CRCR
Corporate Vice President, Revenue Cycle/SBO, Scripps Health
Anita Colon
VP, Revenue Cycle Operations Temple Health
Paul LePage
VP Revenue Cycle, UC Davis
Christine D. Sturtevant, CPA, MHA
VP Revenue Cycle, Vandalia
Sarah Brainard
Vice President of Enterprise Solutions, Office Ally
Blue Cross Blue Shield licensee Hawaii Medical Service Association and Honolulu-based Hawaii Pacific Health are coming together under a new nonprofit parent organization, One Health Hawaii, the organizations confirmed in a Jan. 7 news conference recorded by Hawaii News Now.…
Senators Elizabeth Warren, D-Mass., and Ron Wyden, D-Ore., are expanding their probe into UnitedHealth Group’s nursing home programs after the company provided what they said is an insufficient response to their initial inquiry, along with new allegations of resident deaths.…
House Republicans have asked the leaders of some of the nation’s largest health insurers to testify before Congress at the end of January as scrutiny intensifies over rising healthcare costs and industry profits. On Jan. 22, the CEOs of UnitedHealth…
A team of Stanford (Calif.) University researchers specializing in health law, AI, ethics and medicine identified “risks of supercharged flaws” in harnessing AI for prior authorization in a Jan. 6 Health Affairs report. Prior authorization is a longstanding sore spot…
Today’s group health market is defined by complexity: rising costs, changing risk profiles and heightened expectations from brokers and employers alike. Carriers need more than standalone risk scores; they need complete visibility and control. But too many are stuck with…
Presented by:
Presenters
Andrew Martin
Head of Underwriting, BlueCross NC
Jake Evans, MBA CEBS
Group Health Consultant, Gradient AI
Vince DiBenedetto
Chief Executive Officer, The Provant Group
Highmark now covers all diagnostic breast studies and breast MRIs at 100% without copays or deductibles for members of its Blue Cross Blue Shield plans in Pennsylvania, New York, West Virginia and Delaware. The policy was effective Jan. 1 and…
The No Surprises Act’s independent dispute resolution process continues to be a source of controversy and litigation nationally more than three years after its implementation, with insurers and providers suing over alleged abuse of the arbitration system. The disputes come…
About 20% of Nevadans who actively selected a health plan through the state’s marketplace, Nevada Health Link, picked a new public option, Nevada Health Authority Director Stacie Weeks told lawmakers Jan. 6. In 2025, Nevada secured federal approval for its…
