Priority Health is estimated to have collected at least $4.4 million in Medicare Advantage overpayments throughout 2018 and 2019, according to a March audit from the HHS Office of the Inspector ...

Medicare supplement enrollment grew 1.3% between 2023 and 2024, according to an April report from AHIP, formerly known as America’s Health Insurance Plans. Medicare supplement, or Medigap, is private ...

Premera Blue Cross is suing a weight loss clinic, its physician-owner and its revenue cycle management firm, alleging repeated abuse of the No Surprises Act’s independent dispute resolution process to ...

The day after CMS released its final 2027 Medicare Advantage and Part D payment rule, Chris Klomp, director of Medicare and deputy administrator at the agency, sat down with Health Tech Nerds Radio ...

At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory ...

CMS has issued operational guidance to states regarding how to implement H.R. 1’s Medicaid coverage restrictions for noncitizens, which take effect Oct. 1. On April 8, the agency outlined how states ...

Thirty-six percent of providers believe payers reliably deliver on promises, according to an inaugural Aetna provider survey released April 8. The survey will run quarterly, polling representatives of ...

AP of South Florida, a Florida-based insurance brokerage, has agreed to plead guilty to one count of major fraud against the U.S. for its role in a fraudulent ACA enrollment scheme. In a parallel ...

Washington, D.C. has the highest average monthly premium for ACA enrollees who received advance premium tax credits in 2026, while Texas has the lowest, according to a KFF analysis. After enhanced ...

West Virginia and New Mexico are both launching Medigap “birthday rules” within the next year. Federal law does not include ongoing protections for beneficiaries who want to switch Medicare supplement ...

Elevance Health is bringing its out-of-network provider penalty policy to New York on July 1, continuing a state-by-state expansion that has drawn legislative backlash and opposition from hospitals ...

Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites. 1. Albany (N.Y.) ...