State Farm is involved in ongoing lawsuits alleging a multi-billion dollar scheme in Oklahoma homeowners insurance claims, raising regulatory and compliance issues.
Medicare insurers increasingly adjust plan benefits and formularies to strategically shift sicker beneficiaries, impacting risk pools and competitive dynamics in the Medicare Advantage market.
The UNC Health and Cigna contract lapse leaves tens of thousands out-of-network, highlighting ongoing challenges in hospital-insurer negotiations and payer-provider relationships in North Carolina.
CMS reinstates bonus payments for Medicare Advantage plans and proposes removing administrative star rating measures, impacting key insurers like Humana and UnitedHealth Group.
Legal investigation examines CVS/Aetna's use of AI in denying prior authorizations for post-acute care under Medicare Advantage plans, highlighting regulatory and compliance challenges in insurance claims processing.
Farmers Insurance requests a 6.99% home insurance rate increase as California removes caps on new policies, responding to wildfire risk and regulatory reforms.
A former Michigan pharmacist sentenced to prison for submitting fraudulent Medicare claims totaling $4 million for prescription medications never dispensed, highlighting ongoing challenges in Medicare fraud enforcement.
Recent AAA Foundation data highlights increased aggressive driving behaviors including speeding and cutting off other drivers, affecting auto insurance risk and claims.
The Apples-to-Apples Comparison Act promotes transparency in Medicare by requiring standardized data comparing Medicare Advantage and traditional Medicare, helping seniors make informed choices.
Medicare delays $7.8B hospital drug cost clawback, appeals MA audit ruling, and adds cardiac ablations to ambulatory surgery coverage for 2026.
