Administration and automation are not the only AI use cases payers should be focused on this year, according to McKinsey Senior Partner Adi Kumar, who broke down his 2026 predictions for insurers in a Jan. 12 report. His insights were…
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UnitedHealth Group leveraged “aggressive strategies” to secure higher-paying Medicare Advantage diagnoses, according to a Jan. 12 Senate report. The Wall Street Journal initially covered the news. Senate Judiciary Chair Chuck Grassley, R-Iowa, started an investigation into the insurer’s billing and…
The Blue Cross Blue Shield Association commended the House of Representatives’ vote to extend enhanced ACA tax credits in a Jan. 9 statement shared with Becker’s. A spokesperson said the credits are “the most straightforward and effective step Congress can…
Washington state has fined Kaiser Foundation Health Plan $300,000 for failing to comply with federal mental health parity requirements, though $100,000 of that amount is suspended. The enforcement action came after Kaiser couldn’t provide adequate documentation on provider admission standards…
CMS has become more aggressive with its rollout of new payment and care delivery models. To provide healthcare leaders with an outlook for 2026, research firm ATI Advisory compiled observations from 2025 to gain a sense of CMS’ plans for…
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As Minnesota faces scrutiny over fraud in its public assistance programs, the state is planning to freeze provider enrollment across 13 Medicaid services, according to a Jan. 8 news release from the Minnesota Department of Human Services. The statement said…
Massachusetts will invest an additional $250 million to help residents pay for premium increases after ACA enhanced subsidies expired at the end of 2025. The investment brings the state’s total commitment to its ConnectorCare program to $600 million, the largest…
A Florida insurance brokerage executive will serve nearly three years in prison for participating in a $133 million ACA fraud scheme, the Palm Beach Post reported Jan. 8. Dafud Iza, 54, of Florida, previously served as executive vice president at…
Idaho Gov. Brad Little said he does not support repealing the state’s voter-approved Medicaid expansion program, The Idaho Statesman reported Jan. 8. Mr. Little’s statement comes after a panel of Idaho lawmakers in December recommended repealing the program, which provides…
Senators Elizabeth Warren, D-Mass., and Ron Wyden, D-Ore., are expanding their probe into UnitedHealth Group’s nursing home programs after the company provided what they said is an insufficient response to their initial inquiry, along with new allegations of resident deaths.…