ACA health insurance enrollment has doubled due to expanded subsidies, but political deadlock over extending these subsidies threatens 2026 premiums and market stability.
A federal judge upheld CMS Medicare Advantage star ratings, resulting in a downgrade for Humana that risks billions in government bonus payments. The ruling affects nearly half of Humana's Medicare Advantage members and has broad implications for the insurer and Medicare market.
The California FAIR Plan proposes a 35.8% average premium increase, with hikes up to 50.9% in fire-prone areas, impacting Santa Cruz County homeowners. Insurance professionals should monitor regulatory review and market implications.
State Farm sued in North Carolina for allegedly undervaluing total loss claims by reducing retail values of comparable vehicles, raising regulatory and compliance issues in insurance claim valuations.
Explore the escalating strain on U.S. emergency rooms due to risk of ACA subsidy expirations and significant Medicaid cuts, impacting healthcare access and costs nationwide.
A federal report finds many Medicare Advantage and Medicaid managed care plans list inaccurate mental health providers, affecting access and compliance. Recommendations include using billing data and creating a national provider directory.
CMS limits Medicare payment delays to specific services amid federal shutdown, focusing on telehealth funding lapses and advising providers on claims submissions and patient billing options.
Explore the latest 2025 Medicare Advantage policy updates, including CMS rule changes on prior authorization, risk adjustment models, Star Ratings, supplemental benefits, provider directories, and marketing oversight.
Explore how the Affordable Care Act reshaped the US insurance market by mandating coverage for pre-existing conditions, slowing healthcare cost growth, and highlighting ongoing challenges in drug pricing and insurer practices.
Florida pastor charged with forging a $100,000 life insurance policy on a church member undergoing surgery, highlighting risks of beneficiary fraud in life insurance.
