Democratic governors and attorneys general from 25 states and Washington, D.C., sued the Trump administration June 29 over CMS’ interim final rule implementing Medicaid work requirements. Eight things to know: 1. The 74-page lawsuit, filed in U.S. District Court for…

Health plans are pouring resources into utilization and care management but the total cost of care keeps rising. During a recent webinar hosted by Becker’s Healthcare and ZS Associates, three health plan leaders and Vimbai Mudimu, associate principal at ZS…

Montana is preparing to roll out its community engagement rules for Medicaid July 1, and Arkansas is soft-launching its requirements that same day. HR 1 outlined how low-income, nonpregnant adults ages 19 to 64 must work, perform community service or…

Federal prosecutors and auditors are targeting Medicaid behavioral health fraud on multiple fronts, with billions in alleged false claims under scrutiny nationally and two states alone facing audit findings of more than $123 million combined in potentially improper payments for…

ACA enrollment dropped from 22.1 million in February 2025 to 19.2 million people in February 2026, according to a June 26 HHS report. Immediately following the open enrollment period for 2025 coverage, ACA enrollment reached a record high of 24.2…

One federal lawsuit has set off a chain reaction in the Medicare Advantage world, reshaping star ratings and quality bonus payments — and which plans come out on top. Typically, on the one-to-five star-rating scale, four stars is the threshold…

Walgreens will begin supporting eligible Medicare beneficiaries through the new Medicare GLP-1 Bridge program at about 8,000 pharmacies when the initiative launches July 1. More than 56 million patients in the Medicare network may be eligible for the program, according to a June 25…

St. Louis-based Ascension has become the third-largest ASC operator after its $3.9 billion acquisition of AmSurg expanded its footprint to more than 300 surgery centers. The health system now trails only Tenet Healthcare’s USPI, which operates more than 535 ASCs…

ACA marketplace premiums are on track for a second consecutive year of double-digit increases, according to a June 18 analysis of early rate filings from Georgetown University’s Center on Health Insurance Reforms.  Researchers reviewed publicly available filings from 10 states…

Elevance Health will exit the small group ACA market in Ohio in 2027, the company confirmed with Becker’s. “Small businesses are increasingly seeking health coverage options that deliver affordability, flexibility, and more predictable costs,” an Anthem spokesperson said. “To meet…