CMS is moving to replace four legacy Medicare claims platforms. Now, it is seeking a vendor to design one platform that would assume all four systems’ responsibilities. In a Jan. 8 request for information, CMS said the new platform —…
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Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites. 1. Denver Health sees a senior director of payer contracting. 2. Hartford (Conn.) HealthCare…
Republicans from the House Committees on Energy and Commerce and Ways and Means sent a letter Jan. 9 to the HHS Office of Inspector General over concerns of Medicare fraud in California. The letter focused on home health agencies and…
ACA marketplace enrollment is declining nationally and Congress is struggling to extend the expired subsidies. Five updates on enhanced ACA subsidies: 1. President Donald Trump said Jan. 11 he might veto a bill to extend the subsidies, Bloomberg reported. The…
Sen. Sheldon Whitehouse, D-Rhode Island, Sen. Elissa Slotkin, D-Mich., and Congresswoman Jan Schakowsky, D-Ill., introduced a bill aimed at starting a federal public health insurance option on the ACA marketplace. The Affordable Consumer Health Options and Insurance Competition Enhancement Act…
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ACA open enrollment generally runs until Jan. 15, but Illinois, Connecticut and Pennsylvania are giving their residents more time to choose coverage. While the future of enhanced premium tax credits is still up in the air, the subsidies expired at…
Pennsylvania’s ACA marketplace, Pennie, is shedding roughly 1,000 members each day as premium costs jump following the expiration of enhanced subsidies, the Pennsylvania Capital-Star reported Jan. 8. Pennie has lost at least 70,000 enrollees since November. Current enrollment sits between…
UnitedHealth Group commissioned two independent studies from actuarial firm Milliman highlighting Medicare Advantage savings for both the federal government and beneficiaries. UnitedHealth shared the studies the same day the Senate Judiciary Committee released a report on the insurer’s “aggressive strategies”…
Alignment Healthcare added roughly 65,000 members in 2025, bringing its total enrollment to about 275,300 as of Jan. 1. The Medicare Advantage insurer disclosed the 31% year-over-year growth on Jan. 12, following a strong annual enrollment period. The company has…
CareOregon and Health Share of Oregon have notified members that unauthorized individuals accessed their personal information, which may have been used to create fraudulent claims. The Portland-based insurers learned of the breach Oct. 27 when one or more people viewed…