Special needs plans (SNPs) enrollment is rising and now accounts for 21% of all MA enrollees. According to a new KFF report, that's up from 13% in 2018, when SNPs became a permanent fixture in the ...

Payers are addressing over-payments from every computer click and providers are offsetting denials by deploying AI for the ...

The not-for-profit insurer said it is exiting the individual market across all states and the state of Montana across all ...

Express Scripts has announced a new pharmacy network option that offers "cost plus" drug pricing for employers and health plans. Clients pay the estimated acquisition cost that the pharmacy pays for ...

Three hospitals have sued CVS Health alleging the company redirected $250 million in savings from the 340B program. Mount Sinai Hospital, including St. Luke's-Roosevelt Hospital and Mount Sinai Beth ...

Insurer is eliminating prior auth for many diagnostic procedures, routine surgeries, and cardiology, neurology, pulmonology and orthopedic specialty care.

According to Michael Martin, RapidSOS founder and CEO, the company's platform connects data from billions of devices to help coordinate emergency responses and can even redirect 911 callers to ...

EmblemHealth will pay $2.5 million after an investigation by the Office of the Attorney General in the State of New York found the insurer repeatedly failed to ensure New Yorkers could access mental ...

https://www.businesswire.com/news/home/20260409296812/en/Qventus-Releases-Second-Annual-CIO-Report-Revealing-How-Health-Systems-Are-Closing-the-Gap-Between-AI-Pilots ...

An AMA report and other survey findings point to a healthcare AI landscape that is advancing unevenly across stakeholders.

Employers are becoming more interested in switching to a pharmacy benefit manager they perceive as being more transparent than the “big three,” according to new data published by the National Alliance ...

The projected average total Part D beneficiary premium is projected to decrease by 1.8% in 2024, from $56.49 in 2023 to $55.50 in 2024, according to an announcement Monday from the Centers for ...