Individual coverage health reimbursement arrangements are at an inflection point — payers are catching on, but not to the point of industry mass-adoption, and some employers still have their doubts. Rather than providing a group health plan, employers can offer…
Author: Elizabeth Casolo
BlueCross BlueShield of Tennessee agreed to a settlement with employees who said the company denied their COVID-19 vaccine exemption requests, thus affecting their careers, according to a Dec. 8 filing in the U.S. District Court for eastern Tennessee. The employees…
Minneapolis-based Fairview Health Services submitted a motion Dec. 18 to intervene in the state of Minnesota’s rehabilitation of UCare, which underwent state control Dec. 17. “Fairview should not be required to watch as a bystander while the state unilaterally resolves questions…
UnitedHealth Group’s health services arm, Optum, is shuttering three community centers in the Kansas City area. Optum’s website showed its Converge KC facility in Kansas City, Mo., the Millcreek facility in Shawnee, Kan., and its North Kansas City, Mo., location…
The New York attorney general’s office settled with Centene subsidiary Fidelis Care to refund members who improperly paid for COVID-19 testing visits and some HIV screening services. Under the settlement, Fidelis reprocessed “tens of thousands of claims,” paid more than…
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The Louisiana Department of Health is extending UnitedHealthcare’s Medicaid contract through March 31, the insurer confirmed to Becker’s in a Dec. 18 statement. The state previously decided to cut the contract, which would have expired Dec. 31, thanks to an…
CMS is launching its long-term enhanced accountable care organization design, or LEAD, model at the end of 2026, following the conclusion of the ACO realizing equity, access and community health model. Previously, CMS set a goal to have all traditional…
Payers and providers are locked in an “AI arms race” over coding and claims, but some industry leaders are acknowledging the battle may be a distraction from providing patient care. “The bots battling the bots is a real thing,” Sachin…
Minnesota is rehabilitating UCare, according to a Dec. 17 court filing. The state will take over the insurer’s assets and finances. While providers cannot collect payment from UCare during this time, provider contracts could be modified under the state’s supervision.…
A group of 33 NorthStar anesthesia providers filed a lawsuit against Aetna and Cigna over an alleged $4.1 million in No Surprises Act underpayments, according to Dec. 8 filings in Connecticut’s U.S. District Court. NorthStar said it found claims that…