CMS on June 1 published the interim final rule outlining how states will carry out Medicaid work requirements. The rule sets the operational framework for a policy hospitals warn will push eligible ...

Across three major commercial insurers, only 14% of procedure codes that triggered a prior authorization requirement at one insurer triggered it at all three, according to a study published May 19 in ...

Albuquerque, N.M.-based Presbyterian Healthcare Services will end most of its Medicare Advantage plans in 2027 and lay off about 150 health plan and administrative employees, a spokesperson for the ...

Rate season for individual market coverage in 2027 is underway, with a handful of states among the first to release insurers’ proposed premium filings. The bulk of state filings are not expected to be ...

Arizona Attorney General Kris Mayes accused healthcare data company MultiPlan, rebranded as Claritev, and eight health insurers of a price-fixing scheme. The complaint, filed in state court, alleged ...

CMS published its interim final rule for state implementation of Medicaid work requirements June 1. HR 1 outlined how low-income, nonpregnant people between ages 19 and 64 must work, engage in ...

The HHS Office of the Inspector General estimates $462 million in CMS overpayments to Medicare Advantage plans stemming from some unsupported acute stroke diagnosis codes. In a May report, the OIG ...

A federal judge in Georgia has ruled in favor of Clover Health in its lawsuit challenging its 2026 Medicare Advantage star ratings. On May 27, U.S. District Judge Lisa Godbey Wood partially granted ...

The IRS raised health savings account limits for 2027, with the self-only and family contribution limits rising to $4,500 and $9,000, respectively. For this year’s high-deductible health plan holders, ...

PacificSource is laying off 97 employees following the company’s previously announced decision to exit Montana and the individual line of business, along with “rightsizing in the Oregon market.” The ...

Payers are continuing to trim their workforces amid financial pressures, growing medical and pharmacy utilization, Medicaid funding cuts and strategic restructuring. Below are workforce reduction ...