Payment Integrity Focus Shifts from Fraud to Preventing Overpayments in Healthcare
CMS reports $86B in improper payments, emphasizing payment integrity's role in preventing overpayments and improving healthcare claims accuracy.
Centene Sued Over Alleged Mental Health Provider Directory Failures in Arizona
Centene faces a wrongful death lawsuit in Arizona over allegations of inaccurate mental health provider directories and inadequate access under ACA-compliant plans. The case underscores wider industry compliance and network transparency challenges.
Upcoming Changes to ACA Marketplaces: Impact on Premiums and Enrollment
Explore key updates to the Affordable Care Act Marketplaces amid proposed regulatory and legislative changes affecting premiums, enrollment, and tax credit expirations.
Insurance Coverage Expands for Nutritional Counseling in Chronic Disease Care
More U.S. health insurance plans now cover nutritional counseling to support patients with chronic diseases like diabetes, hypertension, and obesity. This trend enhances holistic care and chronic disease management through personalized dietary guidance.
Concerns Raised Over U.S. House Budget Bill's Medicaid and SNAP Cuts
The U.S. House budget reconciliation bill proposes significant Medicaid and SNAP cuts and large tax reductions, raising concerns about safety net erosion, rising federal debt, and increased income inequality.
U.S. ACA Premium Tax Credit Funding Faces Expiration in 2025, Threatening Coverage for Millions
The expiration of ACA premium tax credits in 2025 could lead to coverage losses for millions and higher insurance premiums, posing market and political challenges.
Medicaid and SNAP Changes Advance with Passage of Republican Bill in House
House Republicans pass bill altering Medicaid and SNAP programs, introducing work requirements and funding restrictions, potentially reducing health coverage for millions. Analysis of legislative impacts on insurance and healthcare access.
Maine Poll Shows Declining Favorability for Health Insurance Companies
New Maine polling reveals only 15% favor health insurance companies, with growing negative views amid debates on AI and pre-authorization regulations.
True Heart Insurance Earns CMS Elite Plus Status for Enrollment Excellence
True Heart Insurance, led by Joshua Dixson, earns CMS Elite Plus status for enrolling 500+ consumers in qualified health plans, enhancing access and expertise in Greenville, SC.
CMS Expands Medicare Advantage Audits Impacting Major Health Insurers
CMS expands Medicare Advantage audits from 2018-2024, intensifying compliance demands and financial scrutiny for major health insurers like UnitedHealth, CVS, and Humana.