The Medicare Part D market is facing an “uncertain future,” according to an analysis from KFF published July 16. The future of the Part D market depends on whether CMS extends the Part D premium stabilization program put in place…
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ACA premiums are set to rise by 15% on average in 2026, The Wall Street Journal reported July 18. The Journal used data analyzed by KFF to report rate increases for the largest insurers in 19 states. BCBS Illinois is…
A new Alaska law takes effect on Jan. 1, 2026 that requires faster responses to prior authorization requests for certain treatments and services, the Alaska Beacon reported July 18. Under the new law, payers are required to notify patients within…
With GLP-1 medication costs being a top concern for employers heading into 2026, UnitedHealthcare is addressing the challenge through its Total Weight Support program, aimed at improving weight loss outcomes for employees while managing the costs of medication adherence. “In…
Canton, Ohio-based Aultman Health System will no longer offer individual and family ACA plans, along with small group insured ACA plans, past 2025, the Canton Repository reported July 21. The system’s insurance arm, AultCare, insures about 100,000 people. About 6,000…
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Healthcare is constantly transforming, and payment integrity programs are facing unprecedented challenges fueled by rising medical spend, an evolving and unpredictable regulatory environment and increasing stakeholder expectations. These trends, coupled with a rapidly accelerating technology landscape, bring payment integrity to…
With healthcare constantly changing and health plans facing unprecedented challenges, payment integrity is at a critical inflection point. At Optum, we’re defining the future of payment integrity as payment precision—helping health plans achieve payment accuracy at claim submission. By advancing…
St. Louis-based Mercy is targeting closer partnerships with fewer organizations, Gavin Helton, MD, president of primary care at the system, told Becker’s. One of these partnerships is with Humana. Mercy and Humana opened their first collaborative 65Prime+ Clinics in Springfield…
CMS and the Department of Homeland Security have entered an agreement that will enable Immigration and Customs Enforcement officials to access the personal data of the nation’s 79 million Medicaid members, according to an exclusive report from The Associated Press. …
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…