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...
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...
January 31, 2024 - Medicare Advantage plan payments will increase by 3.7 percent or $16 billion in 2025, CMS proposed in the Calendar Year (CY) 2025 Advance Notice for the Medicare Advantage and Medicare Part D Prescription Drug Programs.
The proposed payment increase reflects a 2.44 percent effective growth rate, a 0.15 decrease in star ratings from the upcoming...
January 17, 2024 - CMS has finalized requirements for payers to streamline the prior authorization process and improve the electronic exchange of health information to help limit patient care disruptions.
The CMS Interoperability and Prior Authorization Final Rule includes policies for Medicare Advantage organizations, Medicaid and the Children’s Health...