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 ...

CMS elevated Clover Health’s Medicare Advantage star rating from 3.5 to 4.5 for its largest contract, according to a June 9 regulatory filing. Clover’s PPO covers 97% of its members, and the ...

The Council for Affordable Quality Healthcare, owned by major health insurers, is rebranding to DataSpring, powered by CAQH. The company serves as a healthcare data ecosystem for payers and providers.

CareFirst BlueCross BlueShield has secured a two-week pause in its 2026 Medicare Advantage star ratings lawsuit, pointing to a ruling against the government last month that found widespread flaws in ...

Medicare Advantage continued to grow in 2026, but at a slower pace than prior years, as enrollment shifts among major insurers and a surge in special needs plans reshaped the program’s makeup, ...

The House Appropriations Committee moved forward with an amendment that would block funding for a CMS pilot that brings prior authorization requirements to traditional Medicare. The lawmakers adopted ...

The American Psychiatric Association and American Psychological Association Services sent a joint letter to Aetna on June 4 urging the insurer to halt reimbursement rate reductions for behavioral ...

MultiPlan, now rebranded as Claritev, has been at the center of multiple sprawling legal challenges regarding its repricing tools. While some battles have been ongoing, others are just gaining steam.

Regence (Cambia Health Solutions): The four Regence plans reported results by net margin rather than dollar net income, so they are not directly comparable to the dollar figures above. Regence Blue ...

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.

Chicago-based GoHealth has filed for Chapter 11 bankruptcy as part of a prepackaged restructuring plan supported by its lenders and major equity holders. Five things to know: 1. GoHealth, a health ...

Several hospital-insurer contracts are approaching network breaks by the end of June without new agreements in place, spanning multiple states and major insurers. 1. Cigna and Oakland-based University ...