CMS allows 5 states to adopt multiyear continuous Medicaid eligibility for children

The future of such policies is unclear under an upcoming Trump administration, which could rescind approvals or prevent states from implementing waivers.

Oak Street Health co-founder departs CVS

Mike Pykosz, who joined CVS with its acquisition of the value-based medical chain in 2023, is departing amid a flurry of high-level ousters at the struggling company. However, Pykosz is leaving voluntarily, CVS said.

Out-of-network claims slowing you down?

Offering health insurance is becoming less lucrative

In the third quarter, the seven major publicly traded insurers’ medical loss ratios increased an average of 3.3 percentage points year over year — a major jump in medical costs.

If enhanced ACA subsidies expire, 4M could become uninsured: report

The enhanced premium tax credits will expire at the end of next year without action from lawmakers. Republicans have previously criticized the subsidies’ cost.

CMS to lower importance of ‘call center’ metric in Medicare Advantage star ratings

Regulators’ assessment of customer support centers has spurred recent lawsuits from insurers. But the metric “is going to have a smaller weighting on star ratings moving forward,” the director of Medicare said.

Top CMS official urges Trump administration to treat Medicaid with care

“Do to others what you would want done to yourself,” Medicaid director Daniel Tsai said Thursday when asked about advice for his replacement in Trump’s HHS. Trump is expected to cut Medicaid eligibility and funding.

Centene President Ken Fasola to retire next year

Fasola is the second-highest paid executive at the insurer, trailing only CEO Sarah London.

New York Aims to Lower Drug Prices with PBM rules for CVS, Cigna, UnitedHealth

CVS Adds New Directors to Board in Agreement With Hedge Fund Glenview Capital Management