• CMS chops short-term, limited duration plan length to 4 months

    March 29, 2024 - The Biden administration has reduced the timeframe of short-term limited duration insurance plans, also known as “STLDI” or “junk” plans, in an effort to curb underinsurance, CMS announced. “HHS is cracking down on junk insurance plans to help consumers make informed choices and avoid mistakenly paying for a plan that...

  • HHS, payers meet to address Change Healthcare cyberattack response

    March 20, 2024 - Officials from the Department of Health and Human Services (HHS) met with 15 health insurance companies, including major payers and organizations like UnitedHealth Group, Elevance Health, and AHIP, to discuss payers’ Change Healthcare cyberattack response, HHS reported. During the meeting, HHs reviewed the results of a payer survey...

  • UnitedHealth Group Scrutinized for Alleged Antitrust Practices

    February 28, 2024 - The Department of Justice (DOJ) is investigating antitrust allegations against UnitedHealth Group, with a specific focus on the ties between UnitedHealthcare and Optum, according to a Wall Street Journal article that broke the story. Optum’s physician group acquisitions are at the center of DOJ’s inquiries as well as how the...

  • HCSC Announces $3.3B Cigna Medicare Business Acquisition

    February 2, 2024 - HCSC, an independent licensee of the Blue Cross Blue Shield Association, intends to seal the acquisition of Cigna’s Medicare businesses for $3.3 billion, the payer announced. The purchase includes the major payer’s Medicare Advantage plans, Medicare Supplemental Benefits plans, Medicare Part D plans, and CareAllies—which is a...


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Medicaid final rules improve care access for managed care, FFS beneficiaries

CMS has finalized policies to improve access to Medicaid and the Children’s Health Insurance Program (CHIP) managed care and boost coverage quality. The Medicaid and Children’s Health...

Provider markups on specialty drugs increased commercial premiums

Provider markups on specialty drugs increased 2024 commercial health insurance premiums by $13.1 billion, according to research from Oliver Wyman commissioned by AHIP. Provider-administered drugs can...

UnitedHealth Group lost $1.4B in Q1 2024 following cyberattack

UnitedHealth Group experienced a $1.4 billion net loss in the first quarter of 2024, but revenues increased by almost $8 billion year-over-year. The company said the growth and medical care activity...

GAO: states enact own regulations to address pharmacy benefit managers

States have implemented their own regulations to address pharmacy benefit manager (PBM) operations, some of which may prove better routes than national legislation, according to a report from the...

23% of disenrolled Medicaid beneficiaries remain uninsured, KFF finds

Nearly one in four people who were disenrolled from Medicaid remain uninsured, citing costs as barriers to coverage, according to a KFF poll. Since states resumed conducting Medicaid eligibility...

Health savings accounts have mixed effects on healthcare spending, use

Health savings account (HSA) plan enrollment did not impact overall healthcare spending but reduced the use of outpatient services, according to data from the Employee Benefit Research Institute...

Payers react to 2025 Medicare Advantage, Part D Final Rates

Payer trade organizations responded negatively to the 2025 Medicare Advantage and Part D Final Rate Notice, citing rising healthcare costs. “The CMS Final Rate Notice failed to address the...

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