News
Clover Health's win could upend Medicare Advantage star ratings
3+ hour, 48+ min ago (41+ words) Modern Healthcare Clover Health's win could upend Medicare Advantage star ratings Ascension's $3. 9 billion Amsurg acquisition caps years of hospital sales and outpatient investment aimed at shifting more care beyond hospitals....
Presbyterian Health Plan to pull back from Medicare Advantage
1+ day, 17+ hour ago (41+ words) Modern Healthcare Presbyterian Health Plan to pull back from Medicare Advantage States facing Medicaid budget pressure are leaning on insurers to help root out fraud, raising questions about payments, oversight and margins....
Elevance avoids Medicare Advantage enrollment freeze, for now
6+ day, 17+ hour ago (29+ words) Modern Healthcare Elevance avoids Medicare Advantage enrollment freeze, for now The suit claims United Healthcare allegedly received $100 million in fraudulent overpayments....
Clover Health wins Medicare Advantage star ratings lawsuit
1+ week, 15+ hour ago (34+ words) Modern Healthcare News Clover Health wins Medicare Advantage star ratings lawsuit The Centers for Medicare and Medicaid Services must recalculate Clover Health's Medicare Advantage star ratings....
Uninsured rate holds steady at 8. 3% as cuts loom
1+ week, 22+ hour ago (36+ words) Modern Healthcare News Uninsured rate holds steady at 8. 3% as cuts loom Halo MD and others have fended off legal challenges from insurers disputing No Surprises Act arbitrations....
Providence Health Plan to exit Medicaid, ACA, employer markets
2+ week, 1+ day ago (73+ words) Modern Healthcare News Providence Health Plan to exit Medicaid, ACA, employer markets - Providence Health Plan will shed its health insurance exchanges, Medicaid and employer-sponsored coverage next year. - The nonprofit insurer is seeking a national insurer partner to preserve its Medicare…...
How providers are responding to Elevance's out-of-network policy
2+ week, 3+ day ago (35+ words) Modern Healthcare News How providers are responding to Elevance's out-of-network policy The deal is expected to close in the fall, Providence said....
How Medicare Advantage turmoil is disrupting providers, patients
2+ week, 4+ day ago (28+ words) Modern Healthcare How Medicare Advantage turmoil is disrupting providers, patients The health insurance exchanges will undergo major changes next year....
CMS finalizes sweeping ACA marketplace rule
2+ week, 6+ day ago (25+ words) Modern Healthcare News CMS finalizes sweeping ACA marketplace rule The health insurance exchanges will undergo major changes next year....
Why United Health, Elevance, Alignment are bolstering reserves - Modern Healthcare
3+ week, 1+ day ago (33+ words) Why United Healthcare and other insurers are padding reserves Modern Healthcare News Why United Healthcare and other insurers are padding reserves The newly announced initiative is intended to address hurdles to electronic prior authorization uptake....