Twenty-four percent of maternal health providers on Medicaid managed care network lists sent to states are not actually in network, according to the HHS Office of Inspector General. These listings are commonly referred to as “ghost providers,” meaning they appear…

Nationally, roughly 1% of U.S. physicians have opted out of Medicare entirely, according to 2025 data from KFF.  While 1% appears to be a marginal number upon first glance, a closer look at where those exits are happening, and what is accelerating the…

Forty-seven percent of registered voters say corporate health insurance companies are most responsible for rising healthcare costs, according to a new Morning Consult survey. The poll was commissioned by the Coalition to Strengthen America’s Healthcare, a hospital-industry advocacy coalition founded…

The HIV+Hepatitis Policy Institute had accused Blue Cross & Blue Shield of Mississippi of violating federal preventive health coverage requirements with its HIV offerings. The insurer has since updated its formulary to include two of the drugs in question. Mississippi…

More than 2 million fewer children have been enrolled in Medicaid or the Children’s Health Insurance Program since January 2025, according to a June 10 analysis from the Georgetown University McCourt School of Public Policy Center for Children and Families…

From announcing plans to scale back pediatric prior authorization requirements, to nearing a settlement with the Federal Trade Commission in a case involving insulin rebates, here are 10 updates on UnitedHealth Group and its subsidiaries that Becker’s has reported since…

Fairview Health Services will stop scheduling patients with UnitedHealthcare Medicare Advantage plans effective Jan. 1, 2027.  The Minneapolis-based health system said frequent coverage changes, denials and payment issues have made it harder for patients to access care.  “We understand this change creates…

The reality of Medicaid work rules has been setting in, from CMS releasing its implementation framework to health system CEOs modeling the fallout. HR 1 established community engagement requirements for low-income, nonpregnant people between ages 19 and 64, which are…

When Katerina Guerraz, Aetna’s COO, stepped into her role in mid-2024, the company was having, by her own admission, a really tough year. Rather than look for incremental fixes, she and her team decided to set a new direction entirely…

As of fiscal 2023, nearly three-quarters of Medicaid beneficiaries were enrolled in a full-risk managed care organization, up from less than half in fiscal 2010. On June 15, the Medicaid and CHIP Payment and Access Commission, an agency that advises…