CMS plans to cut what Medicare pays hospitals for drugs bought through the 340B program and push site-neutral payment into a new category of outpatient services, two proposals that together would pull ...

Longevity Health has earned a 5-star Medicare Advantage rating for its New Jersey Institutional Special Needs Plan, giving the payer its third 5-star contract following CMS’s recalculation of 2026 ...

Earlier in June, the HHS Office of Inspector General published two reports shedding light on post-acute care denials and overturned appeals from Medicare Advantage organizations. AHIP is pushing back.

CareFirst BlueCross BlueShield has filed a federal racketeering lawsuit against a Maryland insurance broker and his brother, alleging the pair fraudulently enrolled overseas clients in health plans ...

Elevance Health is suing CMS over its 2026 Medicare Advantage star ratings, arguing the agency gave competitor Clover Health a favorable recalculation after losing a court case to the insurer in May.

Nine insurers have announced they will stop offering ACA marketplace plans, either nationally or in specific states, after the 2026 plan year. The withdrawals come amid declining enrollment nationwide ...

Charleston, S.C.-based MUSC Health and Cigna have extended their current contract through Aug. 31 as they continue negotiations on a new agreement. The health system shared the update June 24. MUSC ...

Sustainability has become less about cutting costs and more about redesigning how healthcare delivers value. Becker’s asked several health plan leaders how they’re thinking about long-term ...

“In response to rapid changes in market conditions and industry dynamics, we are undertaking a careful redesign of our organization,” a spokesperson for Independence Health Group told Becker’s. “To ...

Blue Cross and Blue Shield of North Carolina has restructured to become a subsidiary of a new parent holding company, CuraCor Solutions. CuraCor will include Blue Cross NC and other fully owned ...

BCBS companies collectively reported $214.8 billion in revenue in the first half of 2023, according to an Oct. 24 report from Fitch Ratings shared with Becker’s. The report includes financial ...

There are major changes afoot for Medicare Advantage plans in 2024 and when they are required to cover inpatient services in hospitals for their members. The changes are likely to present challenges ...