Author: Andrew Cass

There is a wide variation in Medicaid disenrollment rates across reporting states, ranging from 82 percent in Texas to 10 percent in Michigan, according to a July 24 KFF report. 

The CEO of a laboratory company acquitted in a $1.4 billion fraud scheme is suing six payers, alleging they made false allegations to regulators and prosecutors to avoid paying millions in legitimate claims.

From the HHS Office of Inspector General raising concerns over denial rates to Health Care Service Corporation expanding its use of AI technology, here are four updates on prior authorization reported by Becker's since July 13:

Community Health Plan of Washington named Demetria Malloy, MD, its chief health officer and chief medical officer. 

UnitedHealth Group recently announced that Neil de Crescenzo departed his role as CEO of Optum Insight and was replaced by Roger Connor. In addition to that role, Mr. Connor is continuing to serve as executive vice president of enterprise operations…

Wyatt Decker, MD, who has served as Optum Health's CEO since 2019, is transitioning to the role of chief physician at UnitedHealth Group. 

Patients with UnitedHealthcare plans could go out of network at Orlando (Fla.) Health if the two sides are unable to reach a new contract by July 31, the Orlando Sentinel reported July 18. 

Pittsburgh-based Highmark Blue Shield has added two Southeastern Pennsylvania-based health systems ahead of its move into the region next year, the Philadelphia Business Journal reported July 19. 

A California bill aiming to reform the prior authorization process has advanced out of the Assembly health committee, according to the California Medical Association.

More than 2 million people have lost Medicaid coverage during the redetermination process as of July 13, according to KFF's Medicaid enrollment and unwinding tracker.