Texas lawmakers are urging further action against Superior Health Plan, after the plan’s former CEO admitted to using private investigators to research lawmakers. In an April 10 letter, the members of Texas House Committee on Delivering on Government Efficiency requested…
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Blue Cross Blue Shield will require prior approval for certain severe asthma medications when administered in a healthcare setting, as part of a broader update to its medical policies for self-administered drugs. The change includes four injectibles commonly used to…
The executive vice president of an insurance brokerage firm pleaded guilty to his role in a scheme to submit fraudulent applications to enroll individuals in ACA plans. The purpose of the scheme was to obtain millions of dollars in commission…
Humana’s board of directors declared a $0.885 per share dividend to be paid July 25. The dividend will be paid to all shareholders of record as of the close of business June 27, according to an April 17 Humana news…
UnitedHealth Group’s “unusual and unacceptable” first-quarter results have led the company’s top executives to change their tone regarding CMS’ Medicare Advantage risk adjustment model, known as V28. The V28 is a phased-in change that began in 2024 and will continue…
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Blue Cross Blue Shield of Massachusetts will no longer cover GLP-1 drugs for weight loss as part of its standard benefits, the Boston Globe reported April 17. In a statement shared with Becker’s, a BCBS Massachusetts spokesperson said the company…
Elevance Health is reaffirming that shareholders’ adjusted net income guidance for full year 2025 will be $34.15 to $34.85 per diluted share. The company said in an April 17 regulatory filing that its first quarter results will reflect medical cost…
UnitedHealth Group posted nearly $6.3 billion in net income during the first quarter of 2025, but the company reduced its year-end earnings outlook amid rising use of physician and outpatient services among its Medicare Advantage membership and “unanticipated changes in…
Anthem has reached a settlement in a case alleging its standards for residential mental health coverage were unnecessarily strict. According to an April 15 joint-status filing, Anthem and the plaintiffs in the case reached an agreement in principle on the…
CMS has denied an appeal from Humana to raise its 2025 star ratings, the company disclosed in an April 15 court filing. Humana saw its Medicare Advantage star ratings drop significantly from 2024 to 2025, which will hurt the company’s…