UnitedHealth’s Optum identified $1.7 billion in potential savings if Minnesota would remedy ambiguity in its Medicaid policies, according to a Jan. 31 from the company. As of October, the Minnesota Department of Human Services had contracted with Optum to analyze claims…
Author: Elizabeth Casolo
This February, BCBS Michigan shared how it will cut reimbursement by 50% for nonpreventive evaluation/management services with modifier 25 that were billed on the same day as procedure codes with global periods of zero, 10 or 90 days. Modifier 25…
Younger employees are posing a more substantial cost risk, according to a Feb. 4 whitepaper from UnitedHealthcare and Health Action Council, which focuses on employer healthcare programs. The research relied on data from more than 225,000 HAC members with UnitedHealthcare plans.…
Vermont Republican state Reps. Patricia McCoy and Francis McFaun introduced a bill in January to shake up how payers operate in the state. The proposed legislation grants the governor a greater say in the makeup of health insurance company boards.…
About 1 in 5 claims sent to fully insured commercial health insurers in Massachusetts were denied in 2024, according to February findings from the Massachusetts Health Policy Commission. These insurers submit claim denial data to the commission’s Office of Patient…
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About 4,000 Maryland Health Benefit Exchange customers “were mistakenly notified” of 2026 auto-renewal for CareFirst BCBS coverage, the insurer told Becker’s Feb. 5. CareFirst attributed the error to a “data synchronization issue” with the marketplace and said these individuals did…
Indiana Medicaid will seek proposals from insurers for $68 billion in contracts for Medicaid managed care services, according to a Jan. 30 presentation by the state’s Family and Social Services Administration. The state plans to issue the request for proposals…
CareSource promoted Jason Bearden to regional market president and tapped David Donohue and Eric Van Allen as market presidents for Georgia and Arkansas, respectively, according to Jan. 13 news releases. Mr. Bearden previously oversaw the Georgia market but will now…
Twenty-two groups — most healthcare related — signed a letter advocating for a bill that aims for fairer comparison between Medicare Advantage and fee-for-service, according to a Feb. 4 news release from AHIP. Reps. Aaron Bean, R-Fl., and Kevin Hern,…
Cost Plus Drugs co-founder Mark Cuban is not convinced the Federal Trade Commission’s settlement with Cigna’s Express Scripts is going to amount to much. “My initial response to the FTC [and pharmacy benefit manager] settlements … meh. [G]reat intent. [W]ill…