Kansas Attorney General Kris Kobach filed a lawsuit in state court June 24 against Aetna, alleging the insurer misused tens of millions of dollars while administering the state employee health plan.
Federal prosecutors and auditors are targeting Medicaid behavioral health fraud on multiple fronts, with billions in alleged false claims under scrutiny nationally and two states alone facing audit ...
A federal judge in Georgia has ruled in favor of Clover Health in its lawsuit challenging its 2026 Medicare Advantage star ratings. In a May 27 opinion, U.S. District Judge Lisa Godbey Wood partially ...
The California Hospital Association has filed a lawsuit against Anthem Blue Cross over a policy that would penalize hospitals when patients receive care from out-of-network physicians, even if the ...
The Connecticut Insurance Department fined Aetna, Cigna, ConnectiCare, UnitedHealthcare and Anthem over alleged mental health parity violations, according to an April 15 department report. The report ...
Blue Cross Blue Shield plans faced widespread financial pressure in 2025, with several major insurers posting operating losses as medical and pharmacy costs continue to climb. The struggles played out ...
Insurers have eliminated 11% of prior authorization requirements across a range of medical services since June, representing 6.5 million fewer prior authorizations for members, according to an ...
CMS is raising Medicare Advantage payments by 2.48%, or more than $13 billion, according to its finalized 2027 rate announcement. The agency said April 6 that when estimated risk score trends in MA ...
The Blue Cross Blue Shield Association submitted a wide-ranging letter to CMS on March 30 in response to the agency’s information request on its Comprehensive Regulations to Uncover Suspicious ...
The Maryland Insurance Administration issued Cigna an $80,000 fine and is requiring the insurer to stop automatic downcoding under a recent policy, according to a March 13 letter. Cigna’s evaluation ...
The Medicare Payment Advisory Commission estimated Medicare Advantage payments will be 14% greater than fee-for-service Medicare in 2026, according to a March 12 report from the congressional agency.
A federal magistrate judge in Minnesota has ordered UnitedHealth Group to produce a wide range of documents in an ongoing lawsuit accusing the insurer of using an AI algorithm to wrongfully deny ...
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