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, ...

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 ...

Payers nationwide are striving to operate more efficiently, while maintaining high levels of member and provider satisfaction. Success stems from reducing the friction and costs associated with core ...

Maine is installing a mandatory nutrition program for state employees using GLP-1s for weight loss, according to the state’s Office of Employee Health, Wellness and Workers’ Compensation. As GLP-1 ...

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 ...

The insurance industry has shed nearly 59,000 jobs since the end of 2024, according to new data from the Bureau of Labor Statistics. 1. Insurance carriers and related activities employed approximately ...

As a growing number of hospitals and health systems walk away from Medicare Advantage contracts, Cleveland Clinic is moving in the opposite direction, betting that the path forward runs through the ...

Telehealth programs don’t stall because of a lack of vision; they stall when policy requirements outpace implementation. This session is designed to close that gap. Healthcare leaders from health ...

Payers have faced state penalties in 2026 for slow reimbursements, mishandled member complaints, and mental health parity violations. Fines in 2025 are here. Five insurers — Aetna, Cigna, Molina’s ...

A federal jury has found a 55-year-old Michigan nurse and home health agency owner guilty of committing Medicare fraud using patient records stolen from a Detroit ...

Optum has begun reviewing Minnesota Medicaid claims as part of an enhanced prepayment audit, state officials said, as the state grapples with a widening fraud crisis in its public assistance programs.