Georgia man sentenced to nearly four years in prison and ordered to pay $7.2 million for orchestrating a Medicare fraud scheme involving unnecessary genetic testing and illegal kickbacks.

Medicare Part A costs, including hospital deductibles and skilled nursing coinsurance, are increasing in 2026. Learn about the impact on retirees and the role of Medigap in managing these rising expenses.

Medicare excludes most dental care, leaving retirees with substantial out-of-pocket costs. Explore Dental Savings Plans as a cost-effective supplement to Medicare coverage gaps.

Aetna integrates pharmacy prescriptions with medical procedure prior authorizations to streamline healthcare approvals and enhance payer-provider efficiency through AI-driven digital tools.

OneDigital secures majority investment from CPP Investments and Stone Point Capital in a $7B recapitalization, fueling growth in insurance brokerage and wealth management sectors.

Explore key trends and regulatory updates in Medicare Supplement and Medicare Advantage plans affecting premiums, enrollment, and insurer market exits. Insights for insurance professionals and brokers.

The U.S. Department of Health and Human Services is deploying an AI platform by C3 AI to integrate NIH and Medicare/Medicaid data, enhancing biomedical research and public health analytics. This initiative supports HHS's AI strategy to improve healthcare program integrity and outcomes with secure, interoperable health data systems.

Jefferies upgrades Humana following success in Medicare Advantage portfolio diversification and higher Star Ratings, projecting strong earnings growth for 2026 and 2027 amid regulatory challenges.

CMS is piloting an AI-driven prior authorization program in traditional Medicare across six states to reduce wasteful services and healthcare costs, amidst concerns over delays and administrative burdens.

CMS rescinds Biden-era minimum staffing standards for nursing homes, citing burdens on rural facilities. Public comments open through Feb 2026.