Payer

Pittsburgh-based Highmark Health posted an operating income of $440 million on revenues of $26 billion for fiscal year 2022, but investment slumps resulted in a net loss of $346 million for the year. Excluding investment losses, the company reported net…

A significant data breach of Washington, D.C.'s ACA marketplace in early March has exposed the personal information of at least 17 current or former members of Congress, CBS News reported March 21.

While state approaches to Medicaid redeterminations can vary widely, most states are adopting a few key strategies to promote continuity of coverage, according to a report from Kaiser Family Foundation. 

Geisinger Health Plan received $6.5 million in Medicare Advantage overpayments in 2016 and 2017, according to an audit from HHS' Office of the Inspector General. 

A startup integrating Western medicine and Eastern wellness benefits in Medicare Advantage clinched $41 million in a funding round led by Google Ventures. 

Medicare Advantage plans should be aware of fraudsters turning their efforts to private plans, HHS' Inspector General Christi Grimm said. 

Humana's longest-serving director, David Jones Jr., is planning to retire after 30 years on the company's board, WDRB reported March 20. 

Payers and some provider groups are pushing back on a slate of proposed Medicare Advantage regulatory changes from CMS. Here are nine updates about the program Becker's has reported since March 7. 

New York provides the most comprehensive behavioral health coverage to fee-for-service Medicaid beneficiaries, while South Carolina provides the least, according to an analysis published March 17 by Kaiser Family Foundation.

Mississippi Gov. Tate Reeves vetoed a pair of bills that aimed to speed up the prior authorization process and fine health insurers for inequalities in reimbursement rates, the Mississippi Free Press reported March 16.