Category: Health insurance
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STAT+: CMS halts enrollment in Elevance’s Medicare Advantage plans, citing years of misconduct
STAT+: CMS halts enrollment in Elevance’s Medicare Advantage plans, citing years of misconduct Elevance Health will no longer be able to enroll people into its Medicare Advantage plans starting March 31, according to a new, harshly worded suspension notice from the Centers for Medicare and Medicaid Services. CMS is imposing the punishment after Elevance failed…
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STAT+: Cigna, extending reach into prescription drugs, acquires major pharmacy used by hospitals
STAT+: Cigna, extending reach into prescription drugs, acquires major pharmacy used by hospitals Cigna has acquired CarepathRx, a large pharmacy backed by private equity that dispenses prescription drugs to nearly 10% of U.S. hospitals. The acquisition, discovered by STAT in a review of Cigna’s financial filings, reinforces the company’s push to control more of the…
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STAT+: HHS adviser hopes prior authorization reform happens in ‘double-digit months,’ not years
STAT+: HHS adviser hopes prior authorization reform happens in ‘double-digit months,’ not years WASHINGTON — A top U.S. health official told a room full of doctors on Wednesday that he hopes the Trump administration’s efforts to whittle down the insurance industry’s use of prior authorizations will produce results “in double-digit months” instead of years, calling…
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STAT+: The federal directory of doctors and hospitals is coming this year
STAT+: The federal directory of doctors and hospitals is coming this year After years of grand ambitions, the federal government disclosed that it is months away from rolling out a centralized list of doctors and hospitals filled with up-to-date contact and insurance information. Details of how the national provider directory will work are scant —…
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STAT+: Medicare Advantage growth dwindles for a second straight year
STAT+: Medicare Advantage growth dwindles for a second straight year The Medicare Advantage program continues to bring in more older adults and people with disabilities, but not nearly at the same rates from just a few years ago. Almost 35.5 million people were enrolled in a Medicare Advantage plan as of Feb. 1, up roughly…
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STAT+: Trump officials push for skimpier coverage in ACA marketplaces
STAT+: Trump officials push for skimpier coverage in ACA marketplaces Trump health officials are proposing changes that would water down the options for people who buy their own health insurance through Affordable Care Act marketplaces. The proposals, released this week and which would go into effect in 2027, prioritize making ACA premiums as low as…
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STAT+: TrumpRx: Hype or real savings?
STAT+: TrumpRx: Hype or real savings? You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. Did you snack on HHS-approved MAHA-mole while shaking to Bad Bunny’s Spanish-language celebration of Puerto Rican and Latin…
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New PBM law could open door to direct sales between employers, drugmakers
New PBM law could open door to direct sales between employers, drugmakers WASHINGTON — The pharmacy benefit manager reforms that President Trump signed into law on Tuesday could lead to employers buying drugs directly from drugmakers, just like the administration is encouraging individual consumers to do through its pending website TrumpRx. The PBM reforms are…
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STAT+: New rule would force PBMs to disclose drug rebates and other fees
STAT+: New rule would force PBMs to disclose drug rebates and other fees Pharmacy benefit managers face new, sweeping requirements to disclose all the different ways they get money from providing drug coverage. The proposed rule from the Department of Labor published on Thursday would be a significant change for an industry that shields prescription…
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STAT+: Trump administration signals there’s widespread desire to curb Medicare Advantage
STAT+: Trump administration signals there’s widespread desire to curb Medicare Advantage Health insurers have endured a litany of problems with Medicare Advantage over the past three years. They were optimistic things would turn around with the Trump administration in charge. Tough luck, for now. The administration stunned Medicare Advantage insurers and their investors by proposing…
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STAT+: HCA expects $1 billion hit from loss of ACA tax credits, Medicaid changes
STAT+: HCA expects $1 billion hit from loss of ACA tax credits, Medicaid changes The country’s biggest hospital chain outlined Tuesday what could be a more than $1 billion hit to profit this year from the expiration of federal tax credits and changes to Medicaid payment programs. For many other companies, it’d be a catastrophic…
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STAT+: UnitedHealth limps into 2026 with a smaller business and fresh challenges
STAT+: UnitedHealth limps into 2026 with a smaller business and fresh challenges UnitedHealth Group enters 2026 limping financially after one of the most turbulent years in the company’s history, but executives at the health insurance and services giant made it clear they will cut their way to higher profits. On Tuesday, UnitedHealth said revenue would…
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STAT+: HHS spending bill caught up in ICE debate
STAT+: HHS spending bill caught up in ICE debate You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. To those in the path of this winter storm: Are you rethinking dry January yet?…
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STAT+: Trump administration proposes tiny pay raise to 2027 Medicare Advantage plans
STAT+: Trump administration proposes tiny pay raise to 2027 Medicare Advantage plans The Trump administration plans to increase payments to next year’s Medicare Advantage plans by less than 0.1% on average — far below what the industry had expected. Several Wall Street analysts expected pay increases of 4%-6%, but a crucial measure of Medicare spending…
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STAT+: Former executives of device maker Zynex Medical indicted for fraud
STAT+: Former executives of device maker Zynex Medical indicted for fraud A federal grand jury in Rhode Island indicted two former executives of pain management device company Zynex Medical with multiple counts of health care fraud this week. The indictment alleges that from 2017 through 2025, former Chief Executive Officer Thomas Sandgaard and Chief Operating…
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STAT+: Health insurance execs shift blame for costly, confusing health care system
STAT+: Health insurance execs shift blame for costly, confusing health care system Health insurance executives agree that the U.S. health care system is overpriced, wasteful, and confusing. And they also agree that those problems are someone else’s fault. On Thursday, the CEOs of America’s largest health insurance companies appeared before Congress to both justify their…
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STAT+: What’s in Congress’ sweeping health care deal: PBM reform, telehealth, science funding
STAT+: What’s in Congress’ sweeping health care deal: PBM reform, telehealth, science funding WASHINGTON — Congress has reached a deal on several health care policies, including a crackdown on drug-industry middlemen, transparency measures for hospital billing, pediatric cancer research measures, and Medicare coverage of multi-cancer screening tests. Those measures are part of a bill to…
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STAT+: Trump releases health care plan amid pressure over affordability
STAT+: Trump releases health care plan amid pressure over affordability WASHINGTON — President Trump on Thursday released a hodgepodge of health care policies that would create new price-control power over pharmaceutical companies, but that otherwise wouldn’t fundamentally overhaul America’s existing system, as he faces mounting pressure to address the cost of insurance and care. The…
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STAT+: Negotiations over ACA subsidy bill drag on
STAT+: Negotiations over ACA subsidy bill drag on You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. Inspirational scribbles from baristas have never inspired me, but HHS Deputy Secretary Jim O’Neill was moved…
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STAT+: UnitedHealth has turned Medicare Advantage coding into ‘profit-centered strategy,’ Senate report finds
STAT+: UnitedHealth has turned Medicare Advantage coding into ‘profit-centered strategy,’ Senate report finds UnitedHealth Group’s colossal size has helped the conglomerate turn the way patients are coded in the Medicare Advantage program into “a major profit-centered strategy, which was not the original intent of the program,” according to a new report released Monday from the…
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STAT+: House passes ACA subsidy extension as bipartisan negotiations heat up in Senate
STAT+: House passes ACA subsidy extension as bipartisan negotiations heat up in Senate WASHINGTON — The House voted 230 to 196 to pass a three-year extension of enhanced Affordable Care Act premium subsidies, with 17 Republicans joining all Democrats in favor. Five Republicans did not vote. That the House considered the matter at all shows…
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STAT+: HHS slashes vaccine recommendations
STAT+: HHS slashes vaccine recommendations You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. We’re almost healthy again, according to RFK Jr., though I’m certainly not in top form after my holiday break.…
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Trump tells Republicans to be ‘flexible’ on abortion restrictions to get a health care deal
Trump tells Republicans to be ‘flexible’ on abortion restrictions to get a health care deal President Donald Trump said Tuesday he wants Republicans to reach a deal on health care insurance assistance by being willing to bend on a 50-year-old budget policy that bars federal money from being spent on abortion services. “You have to be a little…
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STAT+: Three major health care policy issues to watch in 2026
STAT+: Three major health care policy issues to watch in 2026 WASHINGTON — Health care figured prominently in the first year of President Trump’s second term, and it’ll likely play an even bigger role leading up to the 2026 midterm elections. The shift back to health care politics has been somewhat surprising. Although Republicans were…
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STAT+: UnitedHealth proclaims audits show it has ‘robust’ procedures, in contrast to findings of independent reviews
STAT+: UnitedHealth proclaims audits show it has ‘robust’ procedures, in contrast to findings of independent reviews UnitedHealth Group said Friday that the consultants it hired to audit its operations, including its practice of applying lucrative diagnosis codes to older adults’ records, found they’re not only “robust,” but “industry leading.” While the reports give a veneer…
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STAT+: House juggles options for extending ACA subsidies
STAT+: House juggles options for extending ACA subsidies You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. Since the election, Cheryl Hines hasn’t spoken to Larry David, her on-screen husband of 24 years…
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STAT+: Medicare routes $16 billion to insurers to offset high drug costs
STAT+: Medicare routes $16 billion to insurers to offset high drug costs The federal government has sent a record $16 billion to health insurers that sell Medicare drug plans, a flashing red sign that prescription drug spending is blowing up far beyond what government officials and insurance experts had expected. The good news for Medicare…
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STAT+: ACA premium spike looms as Senate votes fail, House bill faces long odds
STAT+: ACA premium spike looms as Senate votes fail, House bill faces long odds WASHINGTON — Senators on Thursday failed to pass legislation aimed at controlling health insurance costs for people with Affordable Care Act plans after dueling partisan bills were voted down mostly along party lines. Four Republicans voted for the Democratic bill, while…
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STAT+: Major health insurers to skip J.P. Morgan conference, again
STAT+: Major health insurers to skip J.P. Morgan conference, again For a second straight year, the nation’s largest health insurance companies will not be formally presenting at January’s J.P. Morgan Healthcare Conference, the industry’s premier investor event. Centene, Cigna, CVS Health, Humana, Molina Healthcare, and Oscar Health are not on the initial agenda for the…
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STAT+: Medicare Advantage plans to gain $13 billion under Trump changes to star ratings
STAT+: Medicare Advantage plans to gain $13 billion under Trump changes to star ratings Medicare Advantage insurers scored a Thanksgiving gift, as President Trump’s Medicare agency added back a bonus system that rewards health plans with consistently high marks. The Centers for Medicare and Medicaid Services also is proposing to eliminate a dozen star ratings…
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STAT+: Major health insurers like Humana, UnitedHealth are cutting broker commissions to avoid costly Medicare enrollees
STAT+: Major health insurers like Humana, UnitedHealth are cutting broker commissions to avoid costly Medicare enrollees Major health insurers are taking drastic steps to discourage older adults from signing up for their private Medicare plans as they seek to boost profits, drawing the ire of insurance brokers and state regulators. Humana, UnitedHealthcare, Anthem, and Centene,…
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STAT+: Trump weighs plan to extend extra ACA subsidies for two years
STAT+: Trump weighs plan to extend extra ACA subsidies for two years WASHINGTON — In an about-face, the White House is weighing a proposal to extend the Affordable Care Act enhanced subsidies that Democrats have been clamoring for since last year. ACA health insurance enrollees face a spike in premium payments if Congress does not…
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STAT+: An extension of extra ACA health insurance subsidies looks increasingly unlikely
STAT+: An extension of extra ACA health insurance subsidies looks increasingly unlikely WASHINGTON — Prospects are not looking good for an extension of the extra tax credits that have helped more Americans buy insurance plans in the Affordable Care Act’s marketplaces. Republicans don’t agree among themselves on a proposal, and Democrats don’t like any of…
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STAT+: A revelatory profile of RFK Jr.
STAT+: A revelatory profile of RFK Jr. You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. I haven’t read Olivia Nuzzi’s new book, but I dare say my favorite line about her relationship…
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STAT+: Cassidy pitches his alternative to extending extra ACA subsidies
STAT+: Cassidy pitches his alternative to extending extra ACA subsidies WASHINGTON — Sen. Bill Cassidy (R-La.) is pitching Democrats on his compromise to make Affordable Care Act marketplace plans affordable without extending the extra tax credits that currently lower premium payments. Cassidy, the chair of the Senate health committee, is among the team of Republican…
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STAT+: GOP ACA proposal complicates negotiations
STAT+: GOP ACA proposal complicates negotiations You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. Packing “longevity” items for a flight to a MAHA event in Washington was such a pain that it…
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STAT+: Fate of ACA subsidies still clouded after deal to reopen the government
STAT+: Fate of ACA subsidies still clouded after deal to reopen the government WASHINGTON — Democrats failed to achieve their main objective of extending enhanced Affordable Care Act tax credits in return for reopening the government. The result is that ACA subsidies will remain front and center into December and possibly next year. With a key…
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STAT+: Trump renews a Republican battle cry: Repeal Obamacare
STAT+: Trump renews a Republican battle cry: Repeal Obamacare Over the weekend, in the face of the longest federal government shutdown in history, a familiar refrain has arisen from President Trump and other Republicans: Repeal Obamacare. Republicans have long said Democrats’ Affordable Care Act is to blame for skyrocketing health care costs and what they…
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STAT+: Cassidy drops into Liver Meeting to talk of shutdown, insurance overhaul and vaccines
STAT+: Cassidy drops into Liver Meeting to talk of shutdown, insurance overhaul and vaccines WASHINGTON — On day 39 of the longest government shutdown in U.S. history, Sen. Bill Cassidy (R-La.) said he is still working toward finding bipartisan compromise on health care costs. In a surprise appearance Saturday at the annual American Association for…
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STAT+: UnitedHealthcare drops remote monitoring coverage in defiance of Medicare policies
STAT+: UnitedHealthcare drops remote monitoring coverage in defiance of Medicare policies Beginning in January, UnitedHealthcare will no longer pay physicians to remotely monitor the data that patients collect at home about chronic conditions like hypertension. The updated medical policies for both Medicare and commercial health plans from the country’s largest insurer were posted in September…
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STAT+: UnitedHealth pays its own physician groups 17% more than outside ones, study shows
STAT+: UnitedHealth pays its own physician groups 17% more than outside ones, study shows UnitedHealth Group pays its own physician practices much more than it pays competing practices, a new study finds, reinforcing STAT’s own analysis on the subject and presenting fresh evidence that the conglomerate may be skirting a rule designed to curb health…
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STAT+: Cigna stock nosedives on news that ending PBM rebates will lower that segment’s profit
STAT+: Cigna stock nosedives on news that ending PBM rebates will lower that segment’s profit The stock market pummeled Cigna on Thursday after the company’s leaders revealed that their new plan to ditch pharmacy benefit rebates will lower that segment’s profit in the coming years. By midmorning, the company’s stock had plunged more than 15%. …
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STAT+: UnitedHealth wants to employ more of its doctors
STAT+: UnitedHealth wants to employ more of its doctors After assembling the largest collection of doctors in the U.S., UnitedHealth Group is switching strategies in an effort to improve its financial performance. The company plans to revamp its enterprise of 90,000 clinicians into one more heavily weighted toward employed physicians, rather than affiliated doctors, executives…
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STAT+: Blue Cross plans to target doctors for overcharging. Physicians are furious
STAT+: Blue Cross plans to target doctors for overcharging. Physicians are furious With the help of a computer algorithm, the state’s biggest health insurer says it will scrutinize doctors who frequently bill it for the most expensive patient visits. It will then unilaterally cut payments to physicians it concludes charged too much. Targeting what it…
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STAT+: DeSantis downplays importance of health insurance as the government shutdown drags on
STAT+: DeSantis downplays importance of health insurance as the government shutdown drags on You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. You might have noticed that the subject line of Tuesday’s newsletter…
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Trump announces plan to expand fertility treatment coverage alongside latest pharma deal
Trump announces plan to expand fertility treatment coverage alongside latest pharma deal The Trump administration has struck a deal with EMD Serono to lower drug prices — part of a larger push from the administration to expand coverage and improve affordability for fertility services, officials announced at the White House on Thursday. The administration’s plan…
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STAT+: Blue Cross of Mass. offers buyouts to hundreds of employees amid financial struggles
STAT+: Blue Cross of Mass. offers buyouts to hundreds of employees amid financial struggles Blue Cross Blue Shield of Massachusetts has offered buyouts to hundreds of employees as it seeks to cut its workforce amid soaring health care costs and steep losses. Blue Cross, the state’s largest health insurer, told employees of the voluntary buyouts…
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STAT+: UnitedHealth taps Duke scientist to lead AI efforts
STAT+: UnitedHealth taps Duke scientist to lead AI efforts UnitedHealth Group has tapped a Duke University artificial intelligence expert to be its chief AI scientist as the health care giant ramps up the use of the technology across its sprawling network of businesses, according to a memo obtained by STAT. Michael Pencina, chief data scientist…
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STAT+: House GOP doesn’t include health insurance subsidies in stopgap government funding bill
STAT+: House GOP doesn’t include health insurance subsidies in stopgap government funding bill WASHINGTON — House Republicans on Tuesday introduced a bill to fund the government at current levels until Nov. 21. It would include extensions of several health programs, but not the enhanced tax credits that have significantly lowered premiums for Affordable Care Act…
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STAT+: Bipartisan bill to extend ACA tax credits offers hope for a deal
STAT+: Bipartisan bill to extend ACA tax credits offers hope for a deal WASHINGTON — Republicans in the House and Senate are showing interest in extending the extra subsidies that help make Affordable Care Act health insurance plans cheaper, and that are set to expire at the end of this year. This week, Reps. Jen…
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STAT+: Prasad returns to the FDA, Attack on the CDC
STAT+: Prasad returns to the FDA, Attack on the CDC You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. Normally I keep the intro to this newsletter light-hearted. But today I feel compelled…
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STAT+: DOJ and UnitedHealth reach settlement on $3.3 billion Amedisys deal
STAT+: DOJ and UnitedHealth reach settlement on $3.3 billion Amedisys deal The Department of Justice and state officials have reached a proposed settlement agreement with UnitedHealth Group and Amedisys that would allow the companies to complete their $3.3 billion combination so long as they agree to sell 164 home health and hospice locations across 19…
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STAT+: In health insurers’ race to offload unprofitable members, winners begin to emerge
STAT+: In health insurers’ race to offload unprofitable members, winners begin to emerge If you’ve followed health insurance earnings over the past few weeks, you might be experiencing some whiplash. Four of the biggest players — top names like UnitedHealth Group and Elevance — lowered their profit expectations for the year, while two others —…
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STAT+: Preventive care panel could be restructured ‘imminently’ as RFK Jr. vets new members
STAT+: Preventive care panel could be restructured ‘imminently’ as RFK Jr. vets new members WASHINGTON — Health secretary Robert F. Kennedy Jr. could “imminently” overhaul a key federal advisory panel that recommends which preventive services insurers must pay for, according to a person familiar with the plans. The person said that federal health officials are…
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STAT+: Hospitals boost their profit expectations for 2025 as health insurers stumble
STAT+: Hospitals boost their profit expectations for 2025 as health insurers stumble Two major investor-owned hospital chains upped their 2025 revenue and profit forecasts this week, in stark contrast to health insurers, who’ve been doing the opposite. HCA Healthcare and Tenet Healthcare, for-profit chains that collectively own 240 hospitals, both said their revenue and profit…
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STAT+: 10 million expected to lose health insurance under Trump’s tax cut law, CBO says
STAT+: 10 million expected to lose health insurance under Trump’s tax cut law, CBO says WASHINGTON — President Trump’s major domestic policy law will result in nearly 10 million more people going without health insurance by 2034, according to the Congressional Budget Office’s estimate on the final law. The law, which included significant cuts in…
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STAT+: Judge dismisses Humana’s case over downgraded Medicare Advantage ratings
STAT+: Judge dismisses Humana’s case over downgraded Medicare Advantage ratings A federal judge on Friday tossed out a lawsuit from Humana that attempted to reinstate higher quality ratings to its 2025 Medicare Advantage plans. The ruling jeopardizes billions of dollars in taxpayer-funded bonuses that Humana gets from the government’s star ratings program. However, Humana said…
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STAT+: Survival rates for cancer patients on immunotherapy depend on insurance coverage, study finds
STAT+: Survival rates for cancer patients on immunotherapy depend on insurance coverage, study finds As a cancer patient, access to innovative drugs can help extend your life — that is if you have health insurance, a new study finds. In a JAMA Open Network study published Monday, researchers from the American Cancer Society found that…
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STAT+: How the tax-cut bill that just passed the Senate would upend health care
STAT+: How the tax-cut bill that just passed the Senate would upend health care WASHINGTON — Senate Republicans passed President Trump’s landmark tax bill Tuesday morning, putting transformational health provisions a major step closer to enactment. The bill slashes health care spending by more than $1 trillion over a decade, cuts that would affect patients,…
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Senate passes Trump’s tax-cut bill that would slash Medicaid spending
Senate passes Trump’s tax-cut bill that would slash Medicaid spending WASHINGTON — The Senate passed a $4.5 trillion tax-cut bill after last-minute changes to its health care provisions, as Republicans scrambled to get their party on board. The legislation that passed on Tuesday includes major federal funding cuts to Medicaid that were opposed by hospitals and…
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STAT+: Senate GOP tweaks health care measures in tax bill to win holdouts, please parliamentarian
STAT+: Senate GOP tweaks health care measures in tax bill to win holdouts, please parliamentarian Senate Republicans unveiled late Friday changes to health care policies in tax legislation that they made to win over holdouts in their party and pass muster with budget rules. The changes were made public around midnight, and the long voting…
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STAT+: Insurance coverage of vaccines at risk in RFK Jr.’s reshuffling of CDC’s vaccine advisers
STAT+: Insurance coverage of vaccines at risk in RFK Jr.’s reshuffling of CDC’s vaccine advisers The decision by Health and Human Services Secretary Robert F. Kennedy Jr. to remove and replace all members of the government’s independent vaccine advisory committee doesn’t just change how the nation will approach vaccine policy. It could also take money…
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STAT+: Health insurers promise to reduce barriers to care under pressure from Trump administration
STAT+: Health insurers promise to reduce barriers to care under pressure from Trump administration WASHINGTON — Last week’s pledge from more than 40 health insurers to cut down on prior authorizations came after some behind-the-scenes convincing from the Trump administration. The administration pushed insurers to sign a voluntary pledge to cut back on prior authorizations…
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Medicaid cuts could result in more than 16,000 preventable deaths annually
Medicaid cuts could result in more than 16,000 preventable deaths annually Key health care provisions in the One Big Beautiful Bill Act, especially the proposed Medicaid cuts and Affordable Care Act marketplace reforms, would lead to 16,642 preventable deaths every year if implemented, according to a new analysis published Monday in Annals of Internal Medicine. …
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STAT+: GOP senators zero in on Medicaid policy in Trump’s tax bill that has little impact on enrollment
STAT+: GOP senators zero in on Medicaid policy in Trump’s tax bill that has little impact on enrollment WASHINGTON — A handful of Republican senators want to dial back federal funding cuts to Medicaid in President Trump’s tax cut package, known as the One Big Beautiful Bill. But the changes that most of them are…
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10.9 million people would lose health insurance under Trump’s tax cut bill, CBO projects
10.9 million people would lose health insurance under Trump’s tax cut bill, CBO projects WASHINGTON — House Republicans’ tax bill would lead to nearly 11 million people losing health insurance, providing a key source of savings to help finance President Trump’s tax cuts, according to projections that nonpartisan congressional scorekeepers published Wednesday. Another 5.1 million…
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STAT+: Internal document shows how UnitedHealth executives prepared to tamp down investor unrest
STAT+: Internal document shows how UnitedHealth executives prepared to tamp down investor unrest An internal document drafted in advance of UnitedHealth Group’s shareholder meeting this week reveals how the company’s leadership — facing an extraordinary series of financial and legal challenges — sought to downplay complaints about its business practices and assure jittery investors that…
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STAT+: UnitedHealth conducting ‘comprehensive review’ of Medicare practices that are facing federal scrutiny, new CEO says
STAT+: UnitedHealth conducting ‘comprehensive review’ of Medicare practices that are facing federal scrutiny, new CEO says UnitedHealth Group’s new CEO told investors that the company is reevaluating how it tallies Medicare Advantage patients’ diagnoses for reimbursement purposes, an issue currently under investigation by the Justice Department. Stephen Hemsley’s remarks during the company’s annual shareholder meeting…
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STAT+: How Trump’s tax cut bill would reshape health care
STAT+: How Trump’s tax cut bill would reshape health care WASHINGTON — The House passed President Trump’s tax-cutting plan early Thursday morning with the attendant health care measures to partially pay for it. Relative to earlier drafts, GOP lawmakers revised the bill to further cut government spending, discourage Medicaid expansion, and potentially restrict coverage of…
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STAT+: Trump, building on Biden policy, to speed up audits of Medicare Advantage insurers
STAT+: Trump, building on Biden policy, to speed up audits of Medicare Advantage insurers President Trump’s federal Medicare agency will expedite audits of Medicare Advantage insurers, a move that could claw back nearly $500 million a year for taxpayers, according to previous federal estimates. However, the audits remain mired in a two-year-old lawsuit initiated by…
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STAT+: UnitedHealth’s Optum working on Medicare risk scoring system that would use AI
STAT+: UnitedHealth’s Optum working on Medicare risk scoring system that would use AI SAN DIEGO — Optum, the health data and care provider division of UnitedHealth Group, is developing a way to calculate how sick Medicare patients are through artificial intelligence, instead of relying solely on diagnosis codes submitted by physicians. Ken Cohen, a physician…
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Mental health care may be harder to obtain after HHS rule reversal
Mental health care may be harder to obtain after HHS rule reversal For a recent therapy session, Andria Donaghy’s insurance plan paid her psychiatric nurse practitioner only $11 on a $125 service. “To even put that on paper is insulting,” she said. “These people give their lives [to help others] and that’s what you pay…
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STAT+: Justice Department sues Medicare Advantage insurers and brokers, alleging kickbacks
STAT+: Justice Department sues Medicare Advantage insurers and brokers, alleging kickbacks The Department of Justice has sued three of the largest Medicare Advantage insurers and three dominant insurance brokerages, alleging a scheme in which the health insurers bribed the brokers to steer older adults into their policies. The lawsuit targets CVS Health’s Aetna, Elevance Health’s…
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Luigi Mangione pleads not guilty to federal death penalty charge in UnitedHealthcare CEO’s killing
Luigi Mangione pleads not guilty to federal death penalty charge in UnitedHealthcare CEO’s killing NEW YORK — Luigi Mangione pleaded not guilty Friday to a federal murder charge in the killing of UnitedHealthcare CEO Brian Thompson as prosecutors formally declared their intent to seek the death penalty and the judge warned the Justice Department to stop making…
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STAT+: UnitedHealth discloses $1.7 million in security spending after slaying of top exec
STAT+: UnitedHealth discloses $1.7 million in security spending after slaying of top exec UnitedHealth Group spent nearly $1.7 million on security for its top executives last year, and it appears the expenses all occurred in the final weeks of 2024, after top executive Brian Thompson was killed, new filings show. Thompson was the CEO of…
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STAT+: Trump gives major lift to 2026 Medicare Advantage payments
STAT+: Trump gives major lift to 2026 Medicare Advantage payments Health insurers that sell Medicare Advantage plans are going to get about $30 billion more in taxpayer money next year. President Trump’s Medicare agency finalized a rule Monday that would raise benchmark payment rates to privatized Medicare plans by 5.1% for 2026. That was higher…
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STAT+: Medicare gets a big (unofficial) surprise: a 17-year extension on when it’ll run dry
STAT+: Medicare gets a big (unofficial) surprise: a 17-year extension on when it’ll run dry Medicare’s financial future unexpectedly got a lot rosier, at least according to some federal budget wonks. The Congressional Budget Office recently published its long-term predictions of the federal budget and buried a big surprise for people who follow the Medicare…