Payer

Cigna is being sued by the Justice Department for allegedly making its Medicare Advantage members appear sicker than they were by submitting false diagnosis codes to the government in order to receive higher reimbursement rates.

Apple will reportedly enter the health insurance business in 2024 in partnership with a major payer, Forbes reported Oct. 18.

Despite little growth in the cost of medical services over the last year, inflation has finally caught up with healthcare.

California's first-ever Medicaid managed contract procurements are a major shakeup in the state's Medi-Cal system, which has over 12 million enrollees, or a third of California's population. 

Medically tailored meals could result in large cost savings for payers, a study published Oct. 17 in JAMA Network Open found. 

UnitedHealthcare Community Plan of Texas will invest $5 million in a new facility offering medical and nonmedical assistance to individuals with disabilities, the insurer said Oct. 17.

Here are 13 plans that have announced they are launching new Medicare Advantage plans or expanding current offerings since Oct. 4.

Sanitas Medical Center will open four new Tallahassee, Fla., locations to serve Florida Blue members, the insurer said Oct. 14. 

Payers are implementing utilization management strategies to curb spending on rising specialty drug costs, according to an Oct. 13 panel hosted by the American Journal of Managed Care. 

Centene's Ambetter Health will expand its ACA exchange offerings to Alabama and 60 new counties in 12 states where it already offers plans, the insurer said Oct. 17.