A federal jury in the Southern District of Florida convicted the founder and owner of HealthSplash for his role in a scheme that prosecutors said fraudulently billed Medicare and other federal ...

Two manufacturers filed a lawsuit against Blue Cross and Blue Shield of Texas over alleged prescription drug rebate fraud, according to an April complaint. Texas State Rep. James Frank, a Republican, ...

Iowa Republican Gov. Kim Reynolds signed a law May 13 that enacts prior authorization reforms and prohibits insurers from penalizing providers for out-of-network referrals, according to the Iowa ...

Optum Rx, UnitedHealth Group’s pharmacy benefit manager, said it will roll out a fee-based structure to customers in the coming years. A May 11 news release from Optum said Optum Rx’s agreements have ...

Portland, Ore.-based Legacy Health is back in network with Regence — a Blues carrier under Cambia Health Solutions — according to updates from both organizations. The agreement is retroactive to April ...

Blue Cross Blue Shield plans faced widespread financial pressure in 2025, with several major insurers posting operating losses as medical and pharmacy costs continue to climb. The struggles played out ...

Cigna Healthcare offers the best digital experience to commercial members, while UPMC Health Plan provides the best experience to Medicare Advantage enrollees, according to JD Power’s 2026 U.S.

A federal magistrate judge in Minnesota has ordered UnitedHealth Group to produce a wide range of documents in an ongoing lawsuit accusing the insurer of using an AI algorithm to wrongfully deny ...

The Republican-controlled House Committee on Energy and Commerce sent letters March 3 to ten states — California, Colorado, Massachusetts, Maine, Nebraska, New York, Oregon, Pennsylvania, Vermont and ...

CMS is sanctioning Elevance Health and plans to suspend enrollment into the insurer’s Medicare Advantage prescription drug plans, according to a Feb. 27 agency letter. The enrollment and ...

A coalition of more than 60 employer groups, insurers, patient advocacy and labor organizations sent a letter Feb. 24 to the Treasury Department, Labor Department and HHS, urging the Trump ...