Federal Court Boosts Alignment Healthcare's Medicare Advantage Star Rating
Federal court ruling raises Alignment Healthcare's Arizona Medicare Advantage star rating to 4 stars, impacting quality ratings and bonus payments in 2025.
H.R. 3467 Could Mandate Automatic Enrollment and Lock-In for Medicare Advantage
H.R. 3467 proposes automatic enrollment into low-premium Medicare Advantage plans with a three-year lock-in, raising concerns about beneficiary choice, network limitations, and coverage variability.
Astrana Health Completes $708M Acquisition of Prospect Health to Expand Integrated Care
Astrana Health finalizes $708 million acquisition of Prospect Health, expanding its integrated care network and Medicaid, Medicare Advantage, and commercial coverage. The deal enhances provider scale and care delivery capabilities under California's Knox-Keene health plan regulations.
AHA Issues Q2 2025 Health Care Plan Accountability Update on Medicare Advantage and Private Insurer Regulation
The AHA's Q2 2025 Health Care Plan Accountability Update details key regulatory and legislative changes affecting Medicare Advantage and private health insurer compliance, essential for insurance professionals.
UnitedHealth Group Faces Regulatory Challenges Amid Volatile Stock Dynamics
UnitedHealth Group stock falls amid CMS regulatory changes and DOJ probe, presenting high volatility for investors. Insight into earnings impact and market outlook.
Enforcement and Broker Compliance in Medicare Advantage: Key Insights
Detailed analysis of recent Medicare Advantage enforcement activities focused on broker arrangements, Oak Street settlement, and DOJ False Claims Act litigation impacting healthcare compliance and beneficiary protection.
UnitedHealth Group Faces Operational and Regulatory Challenges Amid Valuation Decline
UnitedHealth Group's stock has dropped over 50% in 2024 amid operational disruptions and DOJ probes, despite strong ROCE. Insights on regulatory risks, Medicare cost pressures, and valuation outlook for investors.
Medicare’s Fiscal Challenges Demand Strategic Reforms for Sustainability
Medicare faces growing financial challenges with rising costs and insolvency risks. Strategic reforms in funding, premiums, and Medicare Advantage are crucial for program sustainability and senior care access.
US Health Insurers Pledge to Simplify Prior Authorization by 2027
Major US health insurers commit to streamlining prior authorization to speed medical approvals and reduce patient/provider friction by 2027.
Walmart Launches Personalized Nutrition Program Targeting Medicare and Medicaid Customers
Walmart introduces a personalized nutrition and wellness program for Medicare and Medicaid users, leveraging data to enhance consumer health and challenge competitors like Costco.