Payer

The year 2024 proved to be a pivotal and tumultuous period for the health insurance industry, defined by the shocking murder of UnitedHealthcare's CEO and the largest cyberattack in the sector's history. Legal and regulatory battles over Medicare Advantage, significant…

HHS' Office of Inspector General estimated three Medicare Advantage insurers received around $11.4 million in overpayments. 

The year 2024 will be remembered as one full of unprecedented challenges and turmoil for the nation's largest healthcare company. 

While most Medicare Advantage plans offer dental benefits, few of these benefits are comprehensive, a study published Dec. 26 in JAMA found. 

An insurer reached a nearly $100 million settlement over allegations of overpayments, and CMS plans to sunset a value-based model over "unprecedented" costs. 

UnitedHealth Group has optimized its ability to increase Medicare Advantage members' sickness scores and corresponding government payments by directly employing thousands of physicians at Optum and integrating sophisticated software tools into clinical workflows, according to a Dec. 29 investigation from…

Climate change is becoming an increasingly urgent challenge for the health insurance industry.

Independent Health will pay up to $98 million to settle allegations a now-defunct subsidiary knowingly submitted invalid diagnoses to boost Medicare Advantage payments. 

Medicaid could spend $29.9 billion on drugs to treat type 2 diabetes and weight loss, according to a report from HHS' Office of Inspector General. 

One in four people in the United States struggle with mental health, and leaders agree that today's system lacks the resources to support them. Issues such as prolonged wait times, inadequate insurance coverage, and a scarcity of providers across the…