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 ...

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 ...

Nebraska will roll out Medicaid work requirements in May, making it the first expansion state to implement these provisions under HR 1. Here are four notes leading up to Nebraska’s launch: 1. Medicaid ...

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 ...

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 ...

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 ...

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 ...

Philadelphia-based Jefferson Health filed a lawsuit against Aetna over its “level of severity inpatient payment policy” for Medicare Advantage beneficiaries, according to an April 6 filing in a ...

As the Medicaid cuts from H.R. 1 begin to settle in, states are looking for workarounds to continue funding their programs. Iowa Republican Gov. Kim Reynolds signed a bill March 25 allowing a steeper ...

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.) ...

CMS is raising Medicare Advantage payments by 2.48%, or more than $13 billion, according to its finalized 2027 rate announcement. The agency said April 6 that when estimated risk score trends in MA ...

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 ...