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Author: Andrew Cass

Prior authorization reforms remain a major advocacy priority for provider trade groups in 2025, and several state lawmakers have also introduced legislation to bring changes to the process.

Portland-based Oregon Health & Science University will go out of network with UnitedHealthcare if the two sides are unable to reach a new contract agreement by March 31, Willamette Week reported Jan. 30. 

Rhode Island lawmakers have introduced legislation that would prohibit payers from requiring prior authorization for treatment or services ordered by a patient's primary care provider. 

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A Minnesota federal judge has given preliminary approval to UnitedHealth's agreement to pay $69 million to settle a class-action lawsuit alleging the company prioritized its business relationship with Wells Fargo over concerns that its 401(k) plan contained low-performing target-date funds.

A Texas lawmaker has introduced a bill that would prohibit payers from using artificial intelligence to delay, deny or modify claims, NBC affiliate KXAN reported Jan. 21. 

Oklahoma Medicaid Director Traylor Rains is leaving the role at the end of January for a job with consulting firm Deloitte, StateImpact Oklahoma reported Jan. 17. 

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