The California Department of Managed Health Care fined Centene’s Health Net $1.3 million for “mishandling [of] provider payment disputes,” according to a Feb. 4 agency news release. California levied an $850,000 fine on Health Net Community Solutions, which provides Medi-Cal…
Author: Elizabeth Casolo
The Federal Trade Commission reached a settlement with Cigna’s Express Scripts in a case over alleged inflation of insulin prices, according to a Feb. 4 agency news release. With the move, the FTC expects to lower out-of-pocket costs for drugs…
Humana saw a 24.3% decrease in inpatient admissions, or a 229,000-stay dip, for Medicare Advantage members in value-based care arrangements versus those in traditional Medicare in 2024, according to Humana’s “12th Annual Value-based Care Report,” published Feb. 4. Humana reviewed…
Sidecar Health selected Sharath Pasupunuti to serve as chief technology officer, according to a Feb. 3 news release. Mr. Pasupunuti will lead engineering, AI strategy, data and platform development in the role, scaling and updating Sidecar systems that automate claims,…
Accountable alternative payment models held steady in 2024, according to a Feb. 2 survey by America’s Health Insurance Plans. In 2024, 44.9% of healthcare payments stemmed from alternative payment models that ensure provider accountability for quality and cost of care.…
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Humana is launching AI-enabled Agent Assist in collaboration with Google Cloud, according to a Feb. 3 news release. Agent Assist aims to personalize and expedite member support by generating real-time conversation summaries, predicting member needs and contributing relevant information efficiently…
Medicaid expansion campaign Florida Decides Healthcare relaunched efforts to collect signatures, now for the 2028 ballot, according to a Feb. 1 news release shared with Becker’s. The proposed amendment would boost Medicaid eligibility for those between ages 18 and 64…
Clever Care Health Plan ushered in almost 15,000 new Medicare Advantage members — membership growth of nearly 50% — during the 2026 Medicare annual enrollment period, according to a Feb. 3 news release from the company. Clever Care offers what…
Melissa Mohon — executive director of compliance, privacy and regulatory affairs for Baltimore-based Johns Hopkins Health Plans — was chosen to chair the Medicare Advantage Plan Alliance Compliance Forum, according to a Feb. 2 news release. As chair, Ms. Mohon…
Participating Medicare Part D plans can officially begin covering weight-loss treatment in 2027. The initiative falls under CMS’ voluntary “Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth” — or BALANCE — model. The December news followed President Trump’s negotiations…