Payer

2024 was a tumultuous year for Medicare Advantage. 

HHS' Office of Inspector General has issued a special fraud alert about the risks of fraud and abuse in certain marketing and compensation arrangements related to Medicare Advantage. 

Four health insurers earned a spot on the latest list of the 250 best-managed companies, as ranked by the Drucker Institute.

UnitedHealth Group has agreed to pay $69 million to settle a class-action lawsuit that alleged the company prioritized its business relationship with Wells Fargo over concerns that its 401(k) plan contained low-performing target-date funds, according to court records. 

In the wake of the targeted killing of UnitedHealthcare CEO Brian Thompson, the New York Police Department is warning other health insurance executives that their safety could also be at risk.

The Federal Trade Commission has sent warning letters to 21 companies marketing or generating leads for health plans regarding concerns over deceptive or unfair claims during open enrollment.

Sachin Jain, MD, CEO of SCAN Group, is sounding the alarm about the growing reliance on centralized call centers across healthcare and how they may inadvertently erode the quality of patient care. 

Optum has backed out of a proposed settlement between Aetna and class members in a lawsuit that accused the companies of improperly charging administrative fees as medical expenses. 

A group of senators is questioning prospective CMS administrator Mehmet Oz, MD, over his stance on Medicare Advantage and his financial ties to MA insurers, NBC News reported Dec. 10. 

Payer CEOs are reckoning with the public vitriol directed at the industry in the wake of the killing of UnitedHealthcare CEO Brian Thompson.