UnitedHealth Medicare Advantage Faces Lawsuits over AI Claims Denials
UnitedHealth Group faces lawsuits and federal probes over AI-driven claims denials in Medicare Advantage, highlighting regulatory risks and the need for ethical plan advisory.
UnitedHealth Cooperates with Federal Investigations into Medicare Advantage Practices
UnitedHealth Group is cooperating with federal criminal and civil investigations into its Medicare Advantage billing practices, amid scrutiny of diagnosis reporting and payments. The insurer faces financial and regulatory challenges influencing the Medicare Advantage market.
UnitedHealth Under DOJ Investigation for Medicare Advantage Fraud
UnitedHealth Group faces DOJ investigation over Medicare Advantage fraud, impacting regulatory compliance and financial outlook for one of the largest U.S. health insurers.
UnitedHealth Faces DOJ Scrutiny Over Medicare Advantage as Industry Faces AI and Market Shifts
UnitedHealth Group responds to DOJ investigations into Medicare Advantage amid broader insurance market changes including AI automation and pharmaceutical supply dynamics.
UnitedHealth Group Faces DOJ Probe into Medicare Advantage Coding Practices
UnitedHealth Group is under DOJ investigation for Medicare Advantage billing practices. The company cooperates with probes on risk adjustment and compliance in health insurance.
DOJ Expands Probe into UnitedHealth’s Medicare Billing Practices
The DOJ is investigating UnitedHealth Group's Medicare billing practices, focusing on diagnostic coding and in-home evaluations that may have led to inflated government payments. This probe highlights compliance and regulatory risks in Medicare Advantage programs.
HCA Healthcare Q2 2024 Earnings Reveal Strategic Growth and Operational Strength
HCA Healthcare's Q2 2024 earnings demonstrate strategic growth fueled by digital transformation, aging demographics, and expansion into non-acute care. Strong financial metrics and operational discipline highlight market leadership.
AultCare to End ACA Individual and Small Group Plans After 2025
AultCare will stop offering individual and small group ACA plans after 2025 due to uncertainty over premium tax credits, continuing Medicare Advantage and group coverage.
CMS and Insurers Launch AI-Driven Medicare Prior Authorization Reforms
CMS introduces WISeR model using AI to expedite Medicare prior authorizations while insurers enhance processes to cut waste and improve care approval speeds.
DOJ-HHS Relaunches False Claims Act Working Group to Intensify Healthcare Fraud Enforcement
The DOJ and HHS have reestablished the False Claims Act Working Group to heighten enforcement of healthcare fraud, focusing on Medicare, Medicaid, pricing, and EHR compliance risks.