The Labor Department’s Employee Benefits Security Administration proposed regulation Jan. 29 that would require pharmacy benefit managers to disclose their compensation with self-insured group health ...

CMS has issued a final rule that will end states’ ability to levy provider taxes to generate additional federal Medicaid matching funds, a financing mechanism the agency characterized as a “loophole.” ...

Point32Health — which includes Harvard Pilgrim Health Care and Tufts Health Plan — appointed Marti Lolli as executive vice president, chief growth officer, and Jeff Weiss as executive vice president, ...

Payer-provider dynamics have been a persistent struggle in healthcare, particularly evident in heated contract negotiations. AI — such as clinicians using scribes associated with greater coding ...

Ten health technology companies have pledged more than $600 million in no-cost and discounted services to help states implement Medicaid work requirements. According to a Jan. 29 news release from CMS ...

BCBS Vermont President and CEO Beth Roberts has worked all over New England — but her latest role marks her first foray into Vermont. She described the state’s insurance market as “interesting” in a ...

Becker’s connected with 17 health plan leaders to see how their organizations are shifting their priorities in response to continued medical cost trend and affordability concerns. Like what you see ...

Medicare Advantage insurers made almost 53 million prior authorization decisions in 2024, according to a Jan. 28 KFF analysis. KFF relied on insurer data reported to CMS, focusing on service ...

Sen. Bernie Moreno, R-Ohio, said his party is preparing to make its “best and final offer” to extend the ACA enhanced tax credits, Politico reported Jan. 28. Mr. Moreno has been a lead negotiator in a ...

Payers are continuing to trim their workforces amid financial pressures, Medicaid funding cuts and strategic restructuring. Below are workforce reduction efforts or job eliminations that were ...

Medicare Advantage has long been viewed as a strong alternative to traditional Medicare, but the program has “deteriorated significantly” in recent years — benefitting commercial payers at the expense ...

UnitedHealth Group reported fourth-quarter and full-year 2025 earnings Jan. 27. Profits took a hit, with the company attributing drops to Medicare funding reductions, the Inflation Reduction Act, ...