Oregon health regulators have flagged three payers for “unreasonably high healthcare cost growth in 2023.” In an October report, the Oregon Health Authority said that Moda Health’s Medicare Advantage ...

Insurers carry out chart reviews to verify alignment between medical records and information submitted by providers. While these reviews can help payers understand a beneficiary’s needs and increase ...

Vermont has the highest average ACA benchmark premium in 2026, while New Hampshire has the lowest, according to KFF. The U.S. average is $625. Premiums were analyzed using the second-lowest cost ...

Connecticut Gov. Ned Lamont signed a bill Nov. 18 requiring insurance companies to extend autism behavioral therapy coverage to include individuals up to 26 years old. Behavioral therapy for autism ...

At the Fall 2025 Becker’s Payer Issues Roundtable, CareSource Senior Vice President Todd Carlson participated in a fireside chat on how the nonprofit payer is modernizing its technology infrastructure ...

Over one-half of eligible Medicare beneficiaries are enrolled in Medicare Advantage plans this year, according to KFF. Given that enrollment and recent scrutiny, all eyes are on how the private ...

A federal court in Florida has approved a $3.4 million class action settlement resolving claims that Aetna improperly denied coverage for proton beam radiation therapy to treat cancer. The lawsuit was ...

Thirteen Democrats in the U.S. House of Representatives introduced eight bills aimed at reforming Medicare Advantage and solidifying traditional Medicare, according to a Nov. 19 news release from Rep.

3. Finance leaders: End-to-end RCM doesn't mean layoffs. Find out what it does mean here.

Over 90% of Medicare Advantage beneficiaries believe that supplemental benefits can improve health and save money, according to a Nov. 20 Humana Healthcare Research survey. Humana’s research ...

Blue Cross of Idaho requested the Idaho Department of Insurance investigate Nutex Health after months of failed negotiations with Nutex’s Post Falls (Idaho) ER & Hospital, according to a Nov. 17 news ...

The Cigna Group is consolidating its board committee structure, dissolving its standalone compliance committee and redistributing oversight responsibilities across other committees, effective Jan. 1.