During a featured session at Becker’s Spring Payer Issues Roundtable in April, leaders from Calm Health and behavioral health provider Magellan Health shared a blueprint for marrying clinical rigor with digital engagement to expand access to behavioral healthcare. Chris Mosunic,…
The investment arm of Marietta, Ga.-based Wellstar Health System, Catalyst by Wellstar, has invested in Venteur, a digital health startup that administers Individual Coverage Health Reimbursement Arrangement plans. ICHRAs allow employers to contribute tax-free dollars to employees’ health benefits, which…
Moody’s Ratings has downgraded UnitedHealth Group’s outlook from stable to negative, citing “a number of adverse trends simultaneously.” The ratings agency also affirmed the company’s strong credit ratings, including its long-term issuer and senior unsecured debt ratings, as well as…
Coventry Health and Life Insurance Co., an Aetna subsidiary, received an estimated $6.9 million in Medicare Advantage overpayments, an audit published by HHS’ Office of Inspector General June 5 found. The government watchdog reviewed a sample of diagnosis codes Coventry…
In a featured session at Becker’s 15th Annual Meeting, Joe Vattamattam, co-founder and president of Healthmap Solutions, presented a data-driven case for value-based kidney care. He emphasized the urgent need for earlier intervention, integrated support, and smarter use of AI…
Seventeen percent of initial Medicare Advantage claims are denied, but 57% of originally denied claims are ultimately overturned, according to a study published June 2 in Health Affairs. The study analyzed 270 million claims from 2019 based on data from…
Reps. Alexandria Ocasio-Cortez and Lloyd Doggett have asked U.S. Attorney General Pam Bondi to expand the Justice Department’s reported civil and criminal investigations into UnitedHealth Group to include allegations that the company has engaged in harmful and fraudulent cost-cutting tactics…
During a featured panel discussion hosted by Kyruus Health at Becker’s Spring Payer Issues Roundtable, leaders from Highmark Health, Allegheny Health Network, Corewell Health and UCare came together to dissect one of healthcare’s quietest crises: provider data inaccuracy. The panel…
Many insurers are asking for double-digit rate increases in 2026 for the individual and small group exchange markets as they face a potential expiration of enhanced premium tax credits and rising costs.
Deceptive marketing practices, including deepfake AI versions of celebrities like Taylor Swift and Joe Rogan, have led to fraudulent enrollment in ACA plans in recent years, according to a June 5 report from Bloomberg. Primarily in 2022 and 2023, AI-created…