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Democrats swept both chambers of Congress in the Nov. 3 midterm elections, leaving the health insurance industry with a new…
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HR 1’s Medicaid work requirements are set to begin Jan. 1. Despite CMS rolling out a framework in June, the work requirements have been met with pushback. The requirements will apply to states that expanded Medicaid or have a similar…
Renton, Wash.-based Providence says it’s owed $1 billion by Medicare Advantage plans. About $600 million of it is from this year alone, according to President and CEO Erik Wexler, and he wants Congress to make payers pay faster. Mr. Wexler…
Your revenue cycle team and your accounting team look at the same payments every day — and often reach two different answers. One reconciles against claims and remittances. The other reconciles against the general ledger and the bank. Both are…
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Molina Healthcare CEO Joseph Zubretsky is now the longest-tenured chief executive among big payers after David Cordani retired as CEO of Cigna on July 1, ending a nearly 17-year run in the role. Here are the CEO tenures at seven…
Medicare beneficiaries in 193 counties across 16 states will have no Medicare Advantage prescription drug plans available for general enrollment in 2027, up from 123 counties in 2026, according to an Oct. 9 KFF analysis of CMS plan landscape data. …
Five insurers lead the industry in public-facing Medicare plan shopping resources, according to an October report from Corporate Insight shared with Becker’s. The report evaluated 18 insurers’ public websites across homepage and menu navigation, Medicare product overview pages, Medicare Advantage…
Health plans are measured on member experience, security, quality and efficiency. Yet one capability quietly underpins all four: Knowing, with confidence, exactly who each member is. As member data spreads across digital and assisted channels, that confidence erodes. Duplicate records,…
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Traylor Rains has been named CEO of Aetna Better Health of Oklahoma. He will lead Medicaid strategy and operations serving SoonerSelect enrollees. Mr. Rains previously served as Oklahoma Medicaid director and has held senior leadership roles with the Oklahoma Department…
Twenty-three percent of Medicaid beneficiaries with hepatitis C received treatment within six months, according to an HHS Office of Inspector General report published Nov. 2. OIG identified roughly 230,000 Medicaid beneficiaries with the disease in 2023. According to the report,…
Tulsa, Okla.-based Hillcrest HealthCare System is no longer in network with Aetna as of Nov. 1. Hillcrest and Aetna have been unable to reach a new agreement, according to the health system. Hillcrest said the update affects roughly 15,000 people…
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