HHS Targets $14 Billion in Savings by Addressing Duplicate Medicaid and ACA Enrollments
HHS and CMS are tackling duplicate enrollments in Medicaid, CHIP, and ACA plans to save $14 billion annually by improving program integrity and reducing waste.
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.
Judge Dismisses Humana's Medicare Advantage Star Rating Lawsuit Pending Appeals
Humana's lawsuit challenging its Medicare Advantage star ratings was dismissed due to incomplete administrative appeals. The insurer faces a major downgrade impacting 2026 earnings and plans further legal action.
ACA Marketplace Premiums Expected to Rise Sharply in 2026 as Subsidies Expire
KFF analysis projects a 75% average increase in ACA marketplace premiums in 2026 due to the expiration of enhanced premium tax credits, impacting millions of enrollees and market stability.
Verisk Analytics Drives Vertical Integration in Life and Annuity Insurance Tech
Verisk Analytics leads vertical integration in life and annuity insurance technology with data-driven platforms enhancing underwriting, payment processing, and healthcare analytics.
DOJ Investigates UnitedHealth Medicare Payment Practices Amid Stock Decline
The DOJ is probing UnitedHealth Group's Medicare Advantage payment practices, with focus on diagnosis coding and compliance. The investigation involves FBI and HHS and impacts stock value amid healthcare sector scrutiny.
DOJ Investigates UnitedHealth Group Over Medicare Advantage Billing Practices
The DOJ is investigating UnitedHealth Group for Medicare Advantage billing practices amid nationwide scrutiny on upcoding, prompting CMS to increase audits of plans and intensify fraud prevention efforts.
UnitedHealth Faces Multiple Shareholder Lawsuits Over Medicare Billing Investigations
UnitedHealth Group faces multiple shareholder derivative lawsuits linked to DOJ investigations of Medicare billing practices, highlighting regulatory and corporate governance issues.
UnitedHealth Group Affirms Medicare Advantage Compliance Amid WSJ Reporting
UnitedHealth Group emphasizes strict regulatory compliance and audit accuracy in Medicare Advantage operations following scrutiny by The Wall Street Journal. CMS audits confirm coding integrity and adherence to federal guidelines.
Medicare Advantage Enrollment Risks: Medigap Underwriting and Switching Limits
Explore the implications of enrolling in Medicare Advantage plans and later switching to original Medicare with Medigap, focusing on medical underwriting and enrollment restrictions that impact U.S. beneficiaries.