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…
Author: Elizabeth Casolo
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…
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…
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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…
CMS will launch a voluntary pilot in 2026 to gather service-level data on prior authorization determinations and appeals in Medicare Advantage, according to a Dec. 16 memo. After the pilot, the agency expects to expand the data-collection efforts to all…
Digital identity wallet service ID.me entered into a contract with CMS, with rollouts to improve secured access and user experience coming to Medicare.gov in early 2026. ID.me will act as an identity verification and sign-in option for the website. User…
Throughout the year, Becker’s touched base with a handful of Elevance Health leaders — including multiple C-suite executives, a clinical lead and a research VP — to get a pulse on the company’s priorities. They discussed AI, doulas and the…