California needs to repay more than $52 million to the federal government after improperly claiming reimbursement from the Medicaid program for some immigrant patients, according to a recently released report from federal inspectors.

Insurers are likely to pay $1.1 billion in Affordable Care Act (ACA) medical loss ratio rebates in 2024, according to a new analysis. Payers have made a total of $11.8 billion in rebates since 2012, when they became required under the ACA, according to a report from KFF and data compiled by Mark Farrah Associates. Health plans ...

Prescription drug ads will soon look different as new federal transparency rules take effect, requiring commercials to clearly spell out potential side effects, essentially ending those rapid-fire disclaimers at the end of many commercials.

Medicare Advantage plan brokers and distributors are asking the federal courts to give them immediate protection against new Centers for Medicare and Medicaid Services agent compensation rules. The plaintiffs predict in three separate suits that plan distribution channels will break down if the courts fail to block the agent comp rules for the 2025 coverage ...

Months into a new Biden administration policy intended to lower drug costs for Medicare patients, independent pharmacists say they’re struggling to afford to keep some prescription drugs in stock. “It would not matter if the governor himself walked in and said, ‘I need to get this prescription filled,’” said Clint Hopkins, a pharmacist and co-owner ...

Major retailers are abandoning or scaling back their ambitions to become health care providers — but don’t look for them to pull out of the market entirely. Why it matters: Retailers hoping to grab a bigger piece of the $4.5 trillion health care market are likely to lean into their core strengths: consumer products, alongside some health services ...