Medi-Cal no longer covers GLP-1s for weight loss as of Jan. 1. Wegovy, Zepbound and Saxenda have been removed from the Medi-Cal Rx Contract Drugs List and are no longer eligible for coverage for ...

Enhanced ACA premium tax credits expired Dec. 31, leaving millions of marketplace enrollees facing higher premiums in 2026. Congressional efforts to extend the subsidies have stalled, with neither a ...

Negotiated prices for 10 Medicare Part D drugs will go into effect Jan. 1, 2026, which could lead to $1.5 billion in out-of-pocket savings, according to a December AARP Public Policy Institute report.

Alabama insurers issued the highest amount of medical loss ratio rebates to consumers in 2024, according to KFF. Under the ACA, if an insurer in the individual market spends less than 80% of premium ...

Delaware’s largest payer controls 93% of the state’s health insurance market, while Washington state’s largest insurer controls just 24%, according to KFF. The 2023 data was obtained from the “Health ...

Health insurers face a wave of regulatory and policy changes in 2026, from the expiration of enhanced ACA premium tax credits to tighter prior authorization rules and new state coverage mandates.

State Medicaid agencies have made an estimated $289 million in improper capitation payments to managed care organizations on behalf of deceased enrollees since 2016, according to a series of audits ...

Mail-order pharmacies owned by UnitedHealth and Humana dispensed Medicare prescription refills earlier and more frequently than industry peers, according to an analysis of federal prescription data ...

The Louisiana Department of Health is extending UnitedHealthcare’s Medicaid contract through March 31, the insurer confirmed to Becker’s in a Dec. 18 statement. The state previously decided to cut the ...

Insurers are publishing incomplete price transparency data, with hospital inpatient information particularly sparse, according to a study published in the American Journal of Managed Care in December.

The payer-provider relationship is continually evolving. Becker’s connected with 13 health plan leaders to find out which part of that relationship they would change. Like what you see here? Join us ...

Senate Democrats are introducing legislation to extend enhanced premium ACA tax credits by three years, according to Senate Minority Leader Chuck Schumer. The bill would come to the Senate floor for a ...