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 ...
A federal judge in Georgia has ruled in favor of Clover Health in its lawsuit challenging its 2026 Medicare Advantage star ratings. In a May 27 opinion, U.S. District Judge Lisa Godbey Wood partially ...
PacificSource Health Plans will exit the individual insurance market, as well as cease all operations in Montana, the company confirmed to Becker’s. “These are not decisions made lightly. We know they ...
The California Hospital Association has filed a lawsuit against Anthem Blue Cross over a policy that would penalize hospitals when patients receive care from out-of-network physicians, even if the ...
Elevance Health has named 45 primary care practices and health systems to its annual Care Provider Recognition Program, recognizing the top 1% of primary care providers for excellence in delivering ...
UnitedHealth Group posted $6.28 billion in profit for the first quarter of 2026, dipping slightly compared to the same period last year. The company released first-quarter earnings April 21, raising ...
The Blue Cross Blue Shield Association submitted a wide-ranging letter to CMS on March 30 in response to the agency’s information request on its Comprehensive Regulations to Uncover Suspicious ...
For the first time, payers must publicly post data on how often they deny prior authorization requests, how quickly they process them and how often denials are overturned on appeal. The first reports ...
A federal magistrate judge in Minnesota has ordered UnitedHealth Group to produce a wide range of documents in an ongoing lawsuit accusing the insurer of using an AI algorithm to wrongfully deny ...
CMS is sanctioning Elevance Health and plans to suspend enrollment into the insurer’s Medicare Advantage prescription drug plans, according to a Feb. 27 agency letter. The enrollment and ...
One in 10 Medicare Advantage enrollees were forced to disenroll from their health plan heading into 2026 due to insurer exits from the market, a tenfold increase from historical averages, according to ...
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