Payer

A Texas state judge handed a victory to system-owned health plans that missed out on Texas' Medicaid contract awards, The Dallas Morning News reported Oct. 4. 

From suing CMS over one phone call to launching its prior authorization gold-card program, here are 10 updates on UnitedHealth Group and its subsidiaries that Becker's has reported since Sept. 11:

States could better leverage Medicaid managed care organizations to promote maternal health, a report from HHS' Office of Inspector General found. 

UnitedHealthcare is expanding its individual and family ACA marketplace plans to four new states and adding 119 new counties in 13 current states for 2025.

The Senate Permanent Subcommittee on Investigations will release a "dramatic" report on Medicare Advantage in the coming weeks, Sen. Richard Blumenthal said. 

A New Jersey-based company has agreed to pay more than $11.3 million to settle False Claims Act allegations arising from fraudulently reported call center performance metrics and fraudulent claims to the South Carolina Department of Health and Human Services.

UnitedHealthcare is asking a federal court to prevent CMS from downgrading its Medicare Advantage star ratings based on one phone call. 

Centene's Ambetter Health individual plans will expand to 60 new counties in 2025. 

The USP Drug Classification PLUS is an offering from USP that provides online, interactive access to the USP Drug Classification (an independent drug classification of FDA-approved drugs, organized by categories and classes) with:

The percentage of Humana Medicare Advantage members enrolled in plans rated 4 stars or higher for 2025 has dropped significantly, which is expected to negatively affect 2026 revenues.