The agency alleged that The Villages Health System, based in the 55-plus community of The Villages in central Florida, submitted false diagnosis codes to increase payments.

A cash-for-coverage plan market veteran thinks that's one of the small rule changes that could make a big difference.

The Congressional Research Service has published an infographic showing that health care providers started 99.9% of the 4.7 million disputes that flowed through the IDR system from 2023 through 2025.

"For 2025, the Individual and Group segments experienced declines in both membership and profitability, with the Individual segment suffering a larger financial impact," according to MFA's "Year-Over-Year Health Insurance Segment Profitability Trends" report.