Officials at Musk-led DOGE were given access to the inner workings of the Centers for Medicare and Medicaid Services (CMS), ...

Mark Shepard, a Harvard Kennedy School expert, looks at the crossroads facing the American health insurance system, a patched ...

Prior authorizations are the way MA managed care plans pre-approve some procedures before they’ll pay for them.

ALBANY — The Albany Med Health System and insurance company CDPHP have reached a new contract agreement after months of negotiation and dispute over underpayments for health services. Albany Med ...

Drugmakers offer “copay assistance programs” to help people afford expensive medicines. But health insurers are milking these ...

Will your care be denied? Medicare Advantage insurers use prior authorization to manage utilization and lower costs. How to compare plans during open enrollment.

Clearwater-based e-Telequote Insurance will soon lay off employees from its Tampa branch, according to a Worker Adjustment and Retraining Notification (WARN) Notice on Feb. 3 to Tampa Mayor Jane ...

And according to an analysis of federal health care data by Value Penguin, of all of the major health insurance companies, ...

Medicaid and dual-eligible contracts fuel growth for the California-based insurer, but also come with upfront implementation costs that will lower its earnings this year, executives said.

Privatized Medicare Advantage plans overbill the U.S. federal government by up to $140 billion per year as they make patients ...

The agreement, announced Wednesday between Kroger and Cigna subsidiary Express Scripts, applies immediately to Medicare prescription drug plans and TRICARE military health plans. Other industry news ...

Fritz reported making "great progress, with Vermont Medicaid reimbursing as expected." Once the Medicare submission issue is resolved, he expects a pending 435 patient reports to be sent then ...