For insurers that remain committed to their Medicare Advantage businesses, special needs plans have been a major growth driver. KFF estimated that almost half of MA enrollment growth from 2024 to 2025 stemmed from these tailored plans. In 2025, SNPs…
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Colorado Access, a health plan known for its Medicaid offerings, is joining the state’s individual ACA market in 2027, according to a March 18 news release from the Colorado Division of Insurance. Through its subsidiary, Access Connected Care Partners, the…
Nine percent of people who had ACA Marketplace coverage in 2025 are now uninsured, with healthcare costs as a major reason many enrollees either switched Marketplace plans or dropped coverage, according to a KFF poll. The KFF follow-up survey of…
Pennsylvania has opened a special enrollment window for 5,400 UnitedHealthcare Medicare Advantage members affected by the contract dispute with Allentown-based Lehigh Valley Health Network, giving impacted beneficiaries until April 30 to switch plans. The state said March 16 that it…
Jersey City, N.J., Mayor James Solomon has hired an auditor to review health insurance claims paid by Horizon BCBS New Jersey, according to a March 17 news release. Horizon previously served as the city’s third-party health insurance administrator. The insurer…
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HSS’ Office of Inspector General estimates that BCBS Alabama received at least $7 million in Medicare Advantage overpayments, according to a March audit report. From a sample of 271 enrollee-years, 247 had medical records that did not align with diagnosis…
Optum Health is about four months into a leadership transition, with its new CEO Krista Nelson laying out her vision for what the care delivery giant looks like after years of rapid expansion that company leadership has acknowledged steered the…
The Trump administration is widening its Medicaid fraud crackdown to Florida, with CMS sending a letter March 17 to Gov. Ron DeSantis and other state leaders that requests information on how the state identifies, prevents and addresses Medicaid program integrity…
Jessica Lopez-Liggett was named commercial state plan president for Anthem’s Indiana business in February, coming at a time when employers nationally are contending with the highest increase in benefits costs in at least a decade. Now about a month in,…
BCBS Illinois has plans to bolster its claims editing and review procedure, the insurer said March 16. The process will change July 1 for office, inpatient and outpatient evaluation and management services. If the billed services do not align with…