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 ...

Washington, D.C. has the highest average monthly premium for ACA enrollees who received advance premium tax credits in 2026, while Texas has the lowest, according to a KFF analysis. After enhanced ...

As the Medicaid cuts from H.R. 1 begin to settle in, states are looking for workarounds to continue funding their programs. Iowa Republican Gov. Kim Reynolds signed a bill March 25 allowing a steeper ...

Elevance Health is bringing its out-of-network provider penalty policy to New York on July 1, continuing a state-by-state expansion that has drawn legislative backlash and opposition from hospitals ...

The Congressional Budget Office estimated the CMS Innovation Center spent $7.9 billion from 2011 through 2020, a March 27 report from the Government Accountability Office said. While some models have ...

Carolina Complete Health and WellCare of North Carolina, both Centene Corp. subsidiaries, secured regulatory approval to move forward with their merger to form a managed care organization, according ...

Houston-based Memorial Hermann Health System’s contract with BCBS Texas expired April 1, rendering the health system out of network. Commercial and ACA exchange (both individual and family) plan ...

Payers are now required to publicly post certain prior authorization metrics, but an initial look at the first set of data offers “little insight into what gets approved or denied, according to an ...

Healthcare has spent the last decade digitizing clinical and financial workflows. Transportation is one of the last major functions still operating without true infrastructure—and it is costing health ...

CMS awarded its Medicare Advantage independent review entity contract to C2C Innovative Solutions, according to a March 31 CMS letter published by the AMA. C2C secured the contract Feb. 26. Effective ...

CMS published its final 2027 Medicare Advantage and Part D rule on April 2, enacting changes to star ratings, supplemental benefits administration, Part D coverage, and a series of deregulatory ...