3+ week, 2+ day ago   (392+ words) SCAN Health Plan and Costco are partnering to provide a suite of insurance products for seniors. SCAN Health Plan and Costco are partnering to launch a suite of insurance products focused on seniors, the companies announced on Tuesday. SCAN is…...

3+ week, 5+ day ago   (291+ words) KFF found that insurers denied 12%-18% of standard prior authorization requests in 2025, with significant variation among insurers and gaps in transparency. In 2025, Medicare Advantage insurers denied 12% of standard prior authorization requests, Medicaid managed care insurers denied 14% and ACA Marketplace insurers denied…...

2+ mon, 3+ day ago   (393+ words) KFF found that ACA Marketplace insurers are proposing a median 14% premium increase for 2027, driven by rising healthcare costs and the expiration of enhanced premium tax credits. Affordable Care Act Marketplace insurers are proposing a median premium increase of 14% in 2027, according…...

2+ mon, 5+ day ago   (277+ words) The star ratings battle continues, this time with Elevance Health. Elevance filed a lawsuit last week against the Department of Health and Human Services and the Centers for Medicare & Medicaid Services, alleging that CMS unlawfully refused to recalculate Elevance’s 2026 Medicare…...

3+ mon, 2+ week ago   (571+ words) CMS finalized a new rule aimed at streamlining the No Surprises Act’s overwhelmed arbitration system. Provider groups largely welcomed the reforms — though some industry leaders said additional changes are still needed to address alleged misuse and improve transparency. The Centers…...

5+ mon, 1+ week ago   (216+ words) In the latest episode of the Debunked podcast, MedCity News Editor-in-Chief Arundhati Parmar and Samir Batra, Managing Partner of Health Innovation Pitch, discussed recent M&A deals and how bots can be manipulated. Several March M&A deals caught the…...

3+ mon, 3+ week ago   (348+ words) Three health systems — Mount Sinai, Michigan Medicine and the University of Kansas Health System — are suing CVS Health, alleging its pharmacy benefit manager diverted roughly $250 million in savings from the 340B program through “spread pricing” between 2020 and 2025. Three health systems are…...

4+ mon, 2+ week ago   (547+ words) Ed Park is sincere and passionate about his calling as the CEO of Devoted Health, which provides Medicare Advantage plans to seniors in 29 states. But it remains to be seen if he can do more or the same with less....

4+ mon, 3+ week ago   (486+ words) At the annual Medicarians conference in Las Vegas that draws brokers, agents, agency owners and field marketing organizations, among others, Dawn Maroney suggested that payers are not always the "bad guys." One big news from the world of Medicare Advantage…...