DOJ Sues California Medicaid Plan Over $320M Misused Federal Funds
The DOJ sues Inland Empire Health Plan for allegedly misusing $320 million in federal Medicaid surplus funds, highlighting compliance challenges in managed care programs.
Stock Decline Impact from CMS's 2027 Medicare Advantage Payment Proposal
Medicare Advantage payment proposal causes stock declines for major health insurers. Find insights on market impact and future projections for 2027.
Brown & Brown Launches National Healthcare Practice for Risk Management
Discover how Brown & Brown's new National Healthcare Practice enhances risk management solutions for healthcare organizations across the nation.
2026 Insights: Stabilizing Healthcare Insurance Industry Trends
Explore the 2026 forecast for the healthcare insurance industry, focusing on managed care trends, firm performance, and investment opportunities for strategic growth.
Nevada Transitions Rural Medicaid to Managed Care Organizations
Nevada shifts Medicaid for 70,000 rural recipients to managed care; challenges in outreach and enrollment highlight rural healthcare access issues.
ILS and OPEN MINDS Partner to Enhance Care Coordination for Vulnerable Populations
Independent Living Systems and OPEN MINDS form a strategic partnership to improve care coordination and community-based supports for vulnerable populations in Medicare, Medicaid, and Dual-Eligible markets.
Cleveland Clinic Joins AmeriHealth Caritas Florida Network in 2026
Starting 2026, Cleveland Clinic expands healthcare access through AmeriHealth Caritas Florida’s network, enhancing provider options for Marketplace and Medicare Advantage members in South Florida.
Home Health Providers Navigate Challenges in Shifting to Value-Based Reimbursement
Home health providers face challenges shifting from fee-for-service to value-based care due to payer demands and regulatory pressures. Innovative payment models and care delivery adaptations are key to success.
Kansas Medicaid KanCare Expands Maternal Care Services and Provider Network
Kansas Medicaid's KanCare expands maternal care services, adding providers and extending postpartum coverage to support pregnant and postpartum beneficiaries through enhanced MCO contracts and reimbursement policies.
CareOregon Ends Out-of-Network Behavioral Health Coverage in Oregon
CareOregon will discontinue out-of-network behavioral health coverage for Medicaid and Medicare Advantage members, impacting 15,000 patients in Oregon. The change aligns with industry practices post-COVID-19 expansion.