Blue Cross Blue Shield of Vermont backed a campaign, called Vermont Affordable Care, focused on comparing pricing policies at independent facilities and academic centers. The initiative — also led by St. Albans, Vt.-based Northwestern Medical Center, Colchester, Vt.-based Green Mountain…
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Oakland, Calif.-based Kaiser Permanente has agreed to pay $556 million to resolve allegations that it violated the False Claims Act by submitting invalid diagnosis codes for Medicare Advantage enrollees to obtain higher payments from the federal government. According to the…
L.A. Care Health Plan is laying off 225 employees by March 13. The insurer told Becker’s the move affects 3% of its workforce and was driven by federal and state Medi-Cal budget reductions, which subsequently led to organizational restructuring. Impacted…
From a Senate report finding the company used “aggressive strategies” to secure higher-paying Medicare Advantage diagnoses to Optum beginning a review of Minnesota Medicaid claims, here are 10 updates on UnitedHealth Group and its subsidiaries that Becker’s has reported since…
Clover Health reported 53% year-over-year growth in Medicare Advantage PPO membership, according to a Jan. 14 news release from the insurer. The growth translated to roughly 153,000 members, building on positive traction from 2025. The company is now expecting to…
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Georgia has issued nearly $25 million in fines to 11 health insurers for violating state mental health parity laws. The penalties follow market conduct examinations that began after a 2023 data call report revealed potential violations of requirements that insurers…
UnitedHealthcare has launched a six-month pilot program aimed at cutting Medicare Advantage payment processing times in half for independent rural hospitals in four states. The Rural Payment Acceleration Pilot will reduce average MA payment timelines from less than 30 days…
CMS is moving to replace four legacy Medicare claims platforms. Now, it is seeking a vendor to design one platform that would assume all four systems’ responsibilities. In a Jan. 8 request for information, CMS said the new platform —…
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. Denver Health sees a senior director of payer contracting. 2. Hartford (Conn.) HealthCare…
Republicans from the House Committees on Energy and Commerce and Ways and Means sent a letter Jan. 9 to the HHS Office of Inspector General over concerns of Medicare fraud in California. The letter focused on home health agencies and…