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Humana plans to open between 20 and 30 primary care clinics in 2025. The company's CenterWell primary care brand will expand to four new metro areas in 2025 — Augusta, Ga., Savannah, Ga., Greensboro, ...

The president of an insurance brokerage firm and the CEO of a marketing company have been charged for their alleged roles in a scheme to submit fraudulent enrollments for fully subsidized ACA plans in ...

UnitedHealthcare is offering some employees buyouts if they leave their job by March 3, CNBC reported Feb. 19. Employees who reject the offer will continue with the company, but layoffs will occur if ...

Payers are focused on leveling up their use of AI and improving members' health outcomes in 2025. Becker's connected with more than a dozen executives at payers across the country to learn what their ...

Blue Cross Blue Shield of Michigan will begin enforcing a long-standing policy that would charge hospitals that repeatedly appeal denied claims. Although the policy has been part of the company’s ...

Centene and one of its subsidiaries will pay $11 million to settle allegations the company falsely certified its compliance with cybersecurity requirements. Health Net Federal Services, which Centene ...

The country's largest payers reported year-over-year increases in medical cost ratios. CVS Health reported the highest medical benefit ratio at 92.5%, driven by increased utilization, the unfavorable ...

Humana's chief medical officer, Kate Goodrich, MD, says CMS' proposed Medicare Advantage rate increase for 2026 "does not fully account for" the rising medical costs experienced by the company over ...

The Trump administration is looking to target 'program integrity' within the Affordable Care Act marketplace with a new proposed rule, while also reducing funding for the ACA navigator program to $10 ...

Medicare Advantage insurers are navigating headwinds in 2025, and new data shows prior authorization requirements within the program continuing to grow. Here are seven Medicare Advantage updates ...

Blue Cross and Blue Shield of Alabama is criticizing a proposed health plan backed by the Alabama Farmers Federation (ALFA), which BCBS says would provide unregulated coverage, harm members, and ...