Elevance Health
Coverage of Elevance Health in the Nexus archive.
- STAT+: Elevance sues government over $115 million tied to Medicare Advantage star ratings
Elevance Health sued the U.S. government, claiming federal recalculation of its Medicare Advantage quality ratings violated a recent court ruling, resulting in a $115 million loss. The lawsuit, filed in Georgia, challenges the impact of revised star ratings on the insurer's eligibility for bonuses and rebates tied to quality thresholds.
- Medicare Advantage Company Pays $342M to Government in Midst of Billing Probe
Elevance Health, a Medicare Advantage company, paid $342 million to the U.S. government to settle allegations of overcharging Medicare for years. The payment followed a CMS enforcement action demanding corrections to billing practices, marking the first time CMS secured such a large repayment from a Medicare Advantage plan.
- The AI boom is giving these execs more power — and headaches — than ever
CFOs are leading AI spending management as companies invest heavily in the technology, implementing budgets and controls to prevent cost overruns. Match Group and Elevance Health are examples of firms introducing structured AI budgets, usage tracking, and vendor selection processes to balance innovation with financial oversight.
- STAT+: Elevance executive ordered to testify in Medicare Advantage fraud case
A federal judge ruled that Peter Haytaian, a former top executive at Elevance Health, must testify under oath in a Department of Justice fraud case involving Medicare Advantage plans. Elevance had blocked the deposition, claiming Haytaian lacked relevant knowledge despite overseeing government health plans for over four years during the alleged overbilling period. The ruling represents a significant victory for the DOJ in a six-year-old case.