Overpayments to Medicare Advantage plans are costing seniors billions, Joint Economic Committee finds

Congressional investigators found Medicare Part B premiums rose by more than $200 per member, totaling $13.4 billion in additional spending, due to the alleged overpayments. Payers slammed the report as flawed.

By Rebecca Pifer Parduhn • March 11, 2026

Optum Rx, Caremark making ‘significant progress’ in settlement talks with FTC

It’s looking increasingly likely that the UnitedHealth and CVS drug middlemen will also make peace with federal regulators, after Cigna agreed to a sweeping settlement in the insulin lawsuit last month.

By Rebecca Pifer Parduhn • March 5, 2026

Mount Sinai, Anthem fail to reach new contract

The New York hospital giant is now out of network with plans offered by the Elevance subsidiary after the two failed to agree on terms.

By Rebecca Pifer Parduhn • March 4, 2026

CMS receives record comments on controversial Medicare Advantage payment proposal

The Trump administration wants to keep MA rates flat next year and change how risk adjustment is calculated. Insurers had a lot to say about this, CMS officials shared Tuesday during an event in D.C.

By Rebecca Pifer Parduhn • March 4, 2026

CMS innovation center remains focused on mandatory models, officials say

CMMI Director Abe Sutton and CMS Administrator Dr. Mehmet Oz outlined how the administration aims to get more providers, especially poor-performing ones, into value-based models at a D.C. event on Tuesday.

By Rebecca Pifer Parduhn • March 4, 2026

State Medicaid budgets face $664B cut due to ‘Big Beautiful Bill’: study

Twenty states are projected to experience Medicaid budget reductions of 5% or more from the law’s cuts to the safety-net insurance program, according to the Rand analysis.

By Emily Olsen • March 3, 2026

CMS threatens Elevance with Medicare Advantage sanctions

Federal regulators are planning to suspend enrollment in Elevance's MA plans at the end of March, in a rare and serious threat to the company’s finances.

By Rebecca Pifer Parduhn • March 3, 2026

Brian Evanko to succeed David Cordani as CEO of Cigna

Evanko, currently the insurer’s COO, will assume the chief executive role after Cordani retires in July.

By Sydney Halleman • March 3, 2026

AMA creates new maternity care coding system

The doctors’ association is blowing up the U.S.’ decades-old coding system for recording pregnancy services and starting fresh next year, bowing to calls from OB-GYNs and other maternity specialists.

By Rebecca Pifer Parduhn • March 2, 2026

Former Optum chief departs UnitedHealth

Heather Cianfrocco, an executive vice president at UnitedHealth and former CEO of its health services division Optum, announced she was leaving the company after a 24-year tenure.

By Sydney Halleman • March 2, 2026

GLP-1s are changing benefits decisions. Here’s how health care decision-makers can stay in control.

GLP-1s: What we know, what’s uncertain and what’s coming next.

By Josh Fredell, Senior Vice President and Head of PBM & Specialty Product Innovation, CVS Caremark • March 2, 2026

Elevance shuffles C-suite as top Carelon exec departs

The leadership changes at Elevance’s main growth engine Carelon — and the company’s decision to centralize oversight of its health plans — come as Elevance looks to bolster waning profits.

By Rebecca Pifer Parduhn • Feb. 27, 2026

How PBM reforms could push drugmakers into the pricing spotlight

The Consolidated Appropriations Act’s landmark PBM overhaul removes financial incentives tied to pharma list prices, potentially leaving drugmakers to defend their own practices.

By Alivia Kaylor • Feb. 27, 2026

Trump administration halts over $259M in Medicaid funds to Minnesota

The funds would be a fraction of the $11.8 billion in Medicaid funding the state receives from the federal government. The Trump administration said the action was part of a broader crackdown on fraud in federal healthcare programs.

By Sydney Halleman • Feb. 26, 2026

Medicare Advantage forced disenrollments rise as insurers exit markets: study

The average rate of forced disenrollments where enrollees had to find a new plan rose from 1% in 2024 to 10% this year, according to research published in JAMA.

By Emily Olsen • Feb. 25, 2026

Medicare Advantage growth decelerates as insurers shed members for 2026

A Healthcare Dive analysis lays out just how drastically insurers retrenched their MA businesses for 2026, with UnitedHealthcare, CVS and Elevance discarding hundreds of thousands of members.

By Rebecca Pifer Parduhn • Feb. 24, 2026

GOP’s ‘Big Beautiful Bill’ erases 12 years of solvency for Medicare trust fund: CBO

Congressional scorekeepers expect the Hospital Insurance trust fund to run dry more than a decade earlier than they previously expected, after Republicans’ megabill slashed the revenues it receives from taxes.

By Rebecca Pifer Parduhn • Feb. 24, 2026

Worker did not plausibly argue obesity was a disability, 1st Circuit finds

In a lawsuit filed against Cigna for refusing to cover weight loss medication, a Maine worker described the condition and its impact too generally, the appeals court said.

By Emilie Shumway • Feb. 23, 2026

Justice Department sues OhioHealth over alleged anticompetitive insurer contracts

The DOJ filed a lawsuit last week accusing OhioHealth of leveraging its market power to force insurers to include its providers in their networks.

By Sydney Halleman • Feb. 23, 2026

Payments for healthcare: How membership-style saves money

Discover how membership-style payment processing helps healthcare providers reduce fees, control costs, and simplify payments without compromising patient experience.

Feb. 23, 2026

Humana’s CenterWell buys primary care provider MaxHealth

The addition of 82 owned and affiliated clinics in Florida comes as Humana doubles down on its primary care portfolio.

By Emily Olsen • Feb. 17, 2026

Why every practice should simplify billing – and how

All providers share an ethical obligation to help their patients avoid unnecessary delays in care, but for small and independent practices the impact can be particularly significant.

Feb. 17, 2026

Lowering drug costs is on Republicans’ minds. Democrats say GOP policies don’t help.

Lawmakers on both sides of the aisle decried the nation’s high drug costs during a House subcommittee hearing last week. Democrats argued Medicaid cuts and lapsed ACA subsidies are worsening the problem.

By Emily Olsen • Feb. 12, 2026

Kaiser reaches settlement with DOL over alleged mental healthcare access failures

The Department of Labor alleged Kaiser didn’t offer adequate provider networks and used patient questionnaires to prevent members from receiving care.

By Ginger Christ • Feb. 11, 2026

House Republicans subpoena 8 health insurers over ACA fraud

The subpoenas request additional documents and information from CVS, Centene, Elevance and more, and suggest House Republicans are considering legislation to combat what they view as rampant fraud in the ACA exchanges.

By Rebecca Pifer Parduhn • Feb. 11, 2026