A federal judge in Indiana has thrown out most claims in a whistleblower lawsuit accusing four insurers and six health systems of improperly billing the state’s Medicaid program, but left the door ...

Premiums for employer-provided coverage could increase by about 5% to 14%, thanks to GLP-1s, according to an Oct. 9 analysis from the Employee Benefit Research Institute. With 55% of employers ...

Optum’s Massachusetts-based subsidiary Atrius Health plans to acquire Acton Medical Associates, a 45-provider primary care group serving nearly 37,000 patients in the Boston area, according to a Sept.

Sentara Health Plans will not offer Medicare Advantage, MA prescription drug HMO, or C-SNP plans in Virginia, North Carolina and Florida in 2026. “These products are no longer financially sustainable ...

Blue Cross Blue Shield of Massachusetts is offering a voluntary separation program to about 18% of its employees — totaling nearly 800 people — a company spokesperson told Becker’s. Employees who are ...

West Virginia may have paid managed care organizations up to $32.4 million for ineligible Medicaid participants, according to an October audit report. The audit examined payments from 2019 to 2020 and ...

Republican lawmakers are reviving proposals that failed to make it into the sweeping One Big Beautiful Bill Act, turning their focus to a trio of measures that could reshape how employers offer health ...

California Gov. Gavin Newsom has signed a bill into law allowing the state’s Department of Managed Health Care to waive prior authorizations for services or prescriptions that payers approve at least ...

Many Medicare Advantage and Medicaid managed care plans lack robust behavioral health networks, according to an October brief from the HHS Office of the Inspector General. The OIG analyzed four MA ...

Pennsylvania lawmakers introduced a bill in October to regulate AI use in health insurance, joining a wave of states attempting to add guardrails in the payer space, especially after an early draft of ...

The Medicare Part D market is entering 2026 amid a period of contraction and recalibration. Premiums are ticking down on average, but plan options are shrinking as major insurers reassess the ...

Cigna has agreed to settle a “ghost network” class-action lawsuit for $5.7 million, according to October federal court filings in Illinois. Plaintiffs Andrew and Andrea Hecht alleged that in 2021, ...