HHS says it has launched a study into “misleading” Medicare Advantage marketing practices “and the harms they cause to individuals.” “In recent years, concerns about aggressive and deceptive marketing practices in Medicare Advantage have become more pressing,” the HHS OIG…
Payer
Insurers are requesting the highest ACA premium increases since 2018, according to an analysis by the Peterson-KFF Health System Tracker published July 18. Insurers are requesting a median increase of 15% based on preliminary rate filings. KFF analyzed rate increase…
CMS will not approve any new waivers for states to allow continuous enrollment for Medicaid or CHIP beneficiaries longer than 12 months. CMS has “concerns about the appropriateness of providing continuous eligibility,” said Drew Snyder, deputy CMS administrator and director…
CMS says it has identified 2.8 million Americans that have possibly either enrolled in Medicaid or CHIP in multiple states or have simultaneously enrolled in both Medicaid/CHIP and a subsidized ACA plan. The agency examined 2024 program enrollment data and…
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. ChristianaCare, based in Newark, Del., seeks a senior director of managed care contracting…
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Elevance Health is the latest insurer to cut its 2025 earnings guidance, citing elevated costs in the individual market and Medicaid. The company reported its second-quarter earnings July 17. Elevance Health earned $2.4 billion in operating income in the second…
Centene added more than 1.2 million individual members between the fourth quarter of 2024 to the first quarter of 2025, according to a report by Mark Farrah Associates. The health plan data aggregator published an analysis of individual market enrollment…
More than half of employers plan to shift more healthcare costs to employees in 2026, according to a survey by Mercer. The consulting firm surveyed 504 large employers on their employee benefit strategies in April 2025. Here are 10 things…
A new, first-of-its-kind report details the corporate structure and acquisition history of the world’s largest healthcare company, UnitedHealth Group. The “Sunlight Report” was published on July 16 by the Center for Health & Democracy and funded by Arnold Ventures. AV…
The California Public Employees’ Retirement System, or CalPERS, has replaced Optum Rx as its pharmacy benefit manager with CVS Caremark. The new five-year contract begins in 2026 and will provide outpatient prescription drug benefits to 587,000 members enrolled in basic…