4+ hour, 15+ min ago  (726+ words) A critical federal incentive program ended in January, raising costs for many. One in three Pennsylvania residents who bought an Affordable Care Act health plan last year has dropped coverage for 2026, after costs more than doubled on average when a…...

2+ mon, 4+ week ago  (188+ words) The federal government's settlement with Aetna followed a record $556 million settlement with Kaiser Permanente in January and a $172 million agreement with Cigna in 2023. Aetna, the second-biggest Medicare Advantage company in the Philadelphia area, has agreed to pay $117. 7 million to settle…...

2+ mon, 2+ day ago  (459+ words) Commonwealth Court said the Pa. Department of Human Services' 2024 selection process for billions in Medicaid business was "arbitrary, capricious, and contrary to law." A Pennsylvania appeals court ordered the state's Department of Human Services to restart the bidding process for…...

2+ mon, 3+ day ago  (435+ words) Aetna's new policy effectively created a two-tier system of inpatient reimbursement that was not negotiated as part of Jefferson's Medicare Advantage contract with Aetna. Jefferson Health sued Aetna Monday over a controversial new policy that reduces payments for hospital stays…...

2+ mon, 1+ week ago  (244+ words) Quality Community Health Care Inc. is four years behind on annual audits required for participation in the federally qualified health center program. Regulators suspended a health clinic in North Philadelphia, Quality Community Health Care Inc. , from a federal program that…...

2+ mon, 1+ week ago  (883+ words) Adults ages 50 through 64 face steep out-of-pocket costs for Obamacare after a set of federal subsidies expired. This could mean even bigger expenses down the road. John Galvin knows he needs a colonoscopy. But he's waiting to schedule the procedure until…...

2+ mon, 1+ week ago  (713+ words) More than 85, 000 people who bought ACA marketplace plans through Pennie last year have dropped their coverage due to rising costs. Sixteen years after the Affordable Care Act expanded access to healthcare for millions of Pennsylvanians, Democratic lawmakers and advocates are…...

2+ mon, 2+ week ago  (809+ words) Lyric. ai helps process insurance claims for 190 million Americans. The process is called claims editing. Carolyn J. Wukitch has a long view on how technology supports payments that are vital to U. S. healthcare. For 35 years, Wukitch has worked at a Newtown Square…...

2+ mon, 3+ week ago  (741+ words) Open enrollment season lasts until March 31 for people enrolled in Medicare Advantage who want to switch to original Medicare, but there's a potential hitch. But there's a catch: If people want to move to original Medicare and buy a supplemental…...

2+ mon, 3+ week ago  (647+ words) The Pa. Insurance Department required Geisinger to maintain specific capital reserve levels as a condition of the deal. Geisinger wants the level to be reduced to free up $100 million. Geisinger Health has asked Pennsylvania regulators for relief from financial conditions…...