Conducting a year-end business checkup is vital for U.S. companies to reduce risk and improve efficiency. Focus on finances, insurance, technology, operations, and workforce strategy for a robust start to the new year.
Patrick C. Moore Jr. sentenced to 46 months and $7.2M restitution for Medicare genetic testing kickback fraud. DOJ and HHS-OIG enforcement highlights healthcare fraud risks.
CMS extends its Medicare Inpatient Rehabilitation Facility Review Choice Demonstration to include Texas and California IRFs, increasing claims oversight and regulatory compliance requirements.
CMS proposes new measures to allow Medicare Advantage enrollees to switch plans mid-year following provider network changes, improving continuity of care for seniors.
Explore the latest trends in U.S. insurance agency mergers and acquisitions for 2026, including market activity, valuation multiples, buyer strategies, deal structures, and internal perpetuation challenges affecting insurance brokers and agencies.
The CMS ACCESS Model launches in 2026 to pilot outcome-focused payments in Original Medicare, expanding technology-supported chronic care and integrating with primary providers for improved patient outcomes.
State Farm is involved in ongoing lawsuits alleging a multi-billion dollar scheme in Oklahoma homeowners insurance claims, raising regulatory and compliance issues.
Medicare insurers increasingly adjust plan benefits and formularies to strategically shift sicker beneficiaries, impacting risk pools and competitive dynamics in the Medicare Advantage market.
The UNC Health and Cigna contract lapse leaves tens of thousands out-of-network, highlighting ongoing challenges in hospital-insurer negotiations and payer-provider relationships in North Carolina.
CMS reinstates bonus payments for Medicare Advantage plans and proposes removing administrative star rating measures, impacting key insurers like Humana and UnitedHealth Group.
