News
AI-powered healthcare fraud has insurers on their toes
8+ hour, 11+ min ago (617+ words) Pulling off health insurance fraud used to take time and skill. Until a few years ago, criminals couldn't fabricate health records without knowing medical terminology and billing codes. If the scheme involved fooling a call center worker, the fraudster would…...
Vladlena Klymova: Medicaid's broken design makes fraud inevitable
1+ week, 5+ day ago (240+ words) Anyone who has suffered a fracture can easily recall the pain " so intense that it demands medication. However, easing the pain alone neither heals the fracture nor keeps the pain from returning later. The pain is merely a symptom " however…...
UPMC, Highmark enjoy strong 1st quarter as health insurance premiums rise
3+ week, 2+ day ago (352+ words) UPMC finances held strong while Highmark started to bounce back from a tough 2025, according to first-quarter earnings reports from the Pittsburgh-based health insurers and hospital networks. The positive showing by UPMC was fueled by its insurance side generating $329 million in…...
Affordable Care Act enrollment projected to plunge by 5 million as costs spike, analysis shows
1+ mon, 23+ hour ago (686+ words) NEW YORK " Nationwide enrollment in the Affordable Care Act health insurance marketplace could plummet by nearly 5 million people this year, shrinking the number of participants in the program by more than 20%, according to a new analysis from the healthcare research…...
Editorial: Eds and meds not immune to financial complications
1+ mon, 1+ week ago (421+ words) Pittsburgh is a city that built itself on steel. When that industry faltered, the city didn't buckle. It reinvented itself with eds and meds " a new identity constructed around health care and the universities that train medical professionals. That can…...
Cal Thomas: Who is monitoring the debt?
1+ mon, 2+ week ago (664+ words) People of a certain age will recall a lyric from the Tennessee Ernie Ford song "Sixteen Tons: "Another day older and deeper in debt. I thought of that song as Secretary of War Pete Hegseth asked Congress to approve a…...
Report identifies 3 UPMC hospitals at risk of closure from Medicaid cuts
1+ mon, 2+ week ago (384+ words) Three UPMC hospitals in Southwestern Pennsylvania are at risk for closure as cuts to Medicaid go into effect, according to a new report from consumer watchdog Public Citizen. UPMC Mercy, UPMC Mc Keesport and UPMC Greene were among the 446 U. S. hospitals…...
Acquisition, not merger: WVU Health System moves to take control of Independence Health's workers, debt
6+ mon, 2+ week ago (672+ words) WVU Health System will acquire the facilities, employees " and debt load " from Independence Health when the two entities are officially joined in the second half of next year, according to hospital officials. It also will gain access to what Independence…...
Independence Health continues to narrow operating losses
4+ mon, 2+ week ago (369+ words) Hefty losses have slowed for Independence Health System in the months leading up to its acquisition by West Virginia University Health System. The five-hospital network said Wednesday its operating losses fell to $7. 3 million in the second half of last year,…...
Deadline for 2026 health insurance through Pennie is almost here
4+ mon, 2+ week ago (397+ words) Pennsylvanians still searching for a 2026 health insurance plan are running out of time to secure it through the Affordable Care Act. Open enrollment on Pennie, the state's Obamacare marketplace, ends just before midnight Jan. 31. Pennie officials had extended the deadline…...