Horizon Blue Cross Blue Shield of New Jersey has agreed to pay $100 million to settle allegations that it fraudulently induced the state to award it a multibillion-dollar contract to administer ...

Optum Health, the care delivery arm of UnitedHealth Group, has named Krista Nelson as its new CEO. “I’m deeply grateful to be part of an organization with such an important mission and an incredible ...

State insurance regulators are issuing warnings around what they describe as unfair practices by Medicare Advantage insurers to restrict enrollment. Amid rising costs and increased regulatory ...

Aetna’s new “level of severity inpatient payment” policy is now set to kick off next year instead of Nov. 15, according to a Nov. 6 company document. As part of the reimbursement approach, Aetna will ...

The Office of the New York City Comptroller approved the NYC Employees PPO plan, according to a Nov. 14 news release. Under the new health plan, EmblemHealth and UnitedHealthcare will take over the ...

Over 8,700 Bronx residents partook in New York City-based EmblemHealth’s community diabetes wellness program in its first year, according to a Nov. 12 news release from the insurer. The program offers ...

3. What if durable medical equipment went from error-prone to seamless? Explore how health plans are rethinking DME end-to-end. Learn more ...

UnitedHealth Group is working to position itself as a frontrunner in the wider healthcare industry’s ongoing technological transformation, with AI at the heart of its strategy to innovate, improve ...

Worcester, Mass.-based UMass Memorial Health and Blue Cross Blue Shield of Massachusetts agreed on a three-year contract set to take effect Jan. 1, according to the insurer. Almost 200,000 UMass ...

Business services provider Conduent faced a data breach going into 2025, leaving insurers scrambling. According to the company, the breach could have revealed members’ names, social security numbers, ...

During fiscal year 2025, Medicaid enrollment dipped while spending grew, according to a Nov. 13 KFF brief. The nonprofit organization hired Health Management Associates to consult state Medicaid ...

Elevance Health is pushing to maintain its health plan contract for New York City employees, according to a Nov. 13 Bloomberg article on the court filings. The news outlet spotted an appeal in the ...