HHS is appealing a judgment that vacated CMS’ Medicare Advantage Risk Adjustment Data Validation program final rule, according to a Nov. 21 filing in the U.S. District Court for the Northern District of Texas. The 2023 final rule allowed CMS…
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Payers have faced state penalties in 2025 for slow reimbursements, improper claims denials, and mental health parity violations. Fines in 2024 are here. Payers fined by states in 2025:
Vermont will have the highest average monthly premiums for the lowest-cost Gold-tier marketplace plan in 2026, while Maryland will have the lowest, according to KFF. The national average is $615. Premiums were analyzed using the lowest-cost premium for a 40-year-old…
Vermont will have the highest average monthly premiums for the lowest-cost Bronze-tier marketplace plan in 2026, while Maryland will have the lowest, according to KFF. The national average is $456. Premiums were analyzed using the lowest-cost premium for a 40-year-old…
Blue Cross and Blue Shield of Minnesota will no longer offer gym memberships for Medicare beneficiaries at YMCA of the North and at Life Time, as of Jan. 1, both gym operators and the insurer confirmed to Becker’s. About 26,000…
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Medicaid information sharing with Immigration and Customs Enforcement officials will pick back up shortly, according to a Nov. 21 CMS notice. “This notice announces CMS policy that CMS will provide certain information to ICE upon request from ICE consistent with…
U.S. Sen. Rick Scott, R-Fla., proposed legislation to “stop giving tax dollars to big insurance companies” and instead redirect premium tax credit amounts to people with a Trump Health Freedom Account, which would mirror a health savings account. “My new…
Vermont will have the highest average monthly premiums for the lowest-cost Silver-tier marketplace plan in 2026, while New Hampshire will have the lowest, according to KFF. The national average is $611. Premiums were analyzed using the lowest-cost premium for a…
Eli Lilly plans to launch a direct-to-employer model for its GLP-1 medications in early 2026 in a move aimed at giving companies more flexibility in designing obesity management benefits for their employees. The model will include three components: flexible benefit…
Oregon health regulators have flagged three payers for “unreasonably high healthcare cost growth in 2023.” In an October report, the Oregon Health Authority said that Moda Health’s Medicare Advantage plans increased costs by 15.4%, PacificSource’s commercial plans grew 7.3%, and…