The No Surprises Act’s independent dispute resolution process has generated an estimated $22.4 billion in total costs over its first four years, according to an analysis published Aug. 26 in Health ...

A former senior director of data analytics at Optum has been sentenced to three years in federal prison for creating a no-show job for a friend and pocketing kickbacks from their salary. Karan Gupta, ...

Health insurers collectively lost $10.4 billion on underwriting in 2025, a dramatic deterioration from $1.7 billion the year before, according to a Mark Farrah Associates analysis. The Aug. 25 ...

Detroit-based Henry Ford Health saw Medicare Advantage membership climb 45.8% year over year during the first half of 2026 as its insurance business helped drive revenue growth. Seven things to know: ...

Nine months after President Donald Trump announced a deal offering states discounted pricing on GLP-1 drugs for Medicaid patients, most states are declining to participate, according to an Aug. 22 ...

Most large health insurers posted stronger-than-expected earnings in the second quarter, but much of the improvement might not be durable, according to a Moody’s Ratings analysis published Aug. 24.

Pittsburgh-based Highmark Health reported $17.5 billion in revenue and $805 million in operating income for the first half of 2026, according to earnings results posted Aug. 24. The organization ...

Tennessee-based in-home care provider Monogram Health has agreed to pay $2.4 million to settle allegations that it caused the submission of false diagnosis codes to boost Medicare Advantage payments.

Earlier this year, health insurance plans covering seniors, low-income people and ACA marketplace enrollees were required to officially begin publicly sharing how often they deny prior authorization ...

Arizona failed to ensure that insurers administering its Medicaid program complied with federal requirements prohibiting stricter prior authorization limits on mental health services compared to ...