Tag: Regulatory Compliance

SelectQuote Faces DOJ Lawsuit over Medicare Advantage Sales Practices

SelectQuote Faces DOJ Lawsuit over Medicare Advantage Sales Practices

SelectQuote Inc. faces a DOJ whistleblower lawsuit over Medicare Advantage sales practices, triggering stock declines and investor class-action suits. Key updates on regulatory compliance and market impact.

CVS Health Expands Nurse-Led Program to Cut Medicare Readmissions

CVS Health's Aetna expands nurse-led program to reduce hospital readmissions among Medicare Advantage members, aligning with CMS readmission penalties effective 2027. Program enhances care coordination and post-discharge support in key U.S. hospitals.

Q2 Earnings Review: Health Insurers Show Varied Growth Amid Regulatory and Economic Challenges

Examination of Q2 earnings for U.S. health insurers reveals growth trends, regulatory challenges, and economic factors shaping market performance in 2024.

CMS Terminates Medicare Agreement with Magnolia Ridge Over Compliance Failures

CMS ends Medicare provider agreement with Magnolia Ridge in Alabama due to failure to meet health and safety standards, leading to termination of Medicare payments for new admissions and impending facility closure.

Two South Florida Men Indicted in $34.8M Medicare Durable Medical Equipment Fraud Scheme

Two South Florida men indicted for a $34.8 million Medicare fraud involving medically unnecessary durable medical equipment and illegal kickbacks. Highlights compliance and regulatory risks in Medicare billing.

Federal Court of Appeal Upholds Patent Application Abandonment Over Maintenance Fee Oversight

The Federal Court of Appeal reinstates a patent abandonment ruling due to missed maintenance fees caused by a data error, underscoring due care requirements in patent administration.

2025 Marks Major Transformation in U.S. Insurance Technology Trends

In 2025, U.S. insurance technology enters a transformative phase driven by AI, IoT, parametric policies, and embedded insurance models, reshaping underwriting, claims, and customer engagement.

Lawsuit Accuses State Farm of Claim Mishandling and Racial Discrimination

A federal lawsuit alleges State Farm mishandled an auto claim and discriminated against a Black policyholder, raising compliance and claim handling concerns in the auto insurance industry.

HCSC Expands Medicare Advantage Plans to 30 States and DC for 2026

Health Care Service Corporation expands its Medicare Advantage coverage to 30 states and DC, enhancing its national presence with diverse plan options for 2026.

FTC Warns Healthcare Employers on Noncompetes; Industry Sees Rising Unionization and Tech Advances

FTC cautions healthcare employers on noncompetes. Rising physician unionization, Medicare Plan Finder updates, Kaiser-Renown joint venture, AI tools, FDA drug approvals, and robotic intubation device mark key healthcare industry trends in 2025.