Catastrophic health events — such as brain injuries and amputations — are life altering for patients, but these claims also weigh on insurers. From rising utilization and medical costs to expanded eligibility for catastrophic health coverage, the role of these…
Author: Elizabeth Casolo
Viva Health, under the University of Alabama at Birmingham Health System, said it is investigating a data breach involving 4,945 individuals’ data, according to a news release from Sept. 26 shared with Becker’s. The insurer found a file on its…
AmeriHealth Caritas, a managed care organization, is growing its Medicare Advantage offerings, focusing on its Medicare-Medicaid dual-eligible special needs plans, according to a news release shared with Becker’s. In 2026, the insurer’s MA dual-eligible offering will be available in new…
Work requirements for Medicaid eligibility are set for 2027, but states can request short-term exceptions for counties with high unemployment. By assessing county-level data in Medicaid expansion states, KFF found only 7% of counties meet the exception criteria using a…
Average premiums, benefits and plan choices for Medicare Advantage and the Medicare Part D prescription drug program should remain relatively stable next year, CMS said in a Sept. 26 news release. But MA enrollment is projected to decrease 900,000 in…
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Commercially insured patients pay substantially different rates for the same procedure, with negotiated costs for inpatient procedures varying by an average ratio of 9.1, according to an August report from market intelligence firm Trilliant Health. The report reviewed health plan…
An estimated 3 out of 5 U.S. children have been enrolled in Medicaid or the Children’’s Health Insurance Program, according to a Harvard T.H. Chan School of Public Health model. As of 2024, states must provide a year of continuous…
Brewer, Maine-based Northern Light Health President and CEO Timothy Dentry voiced frustration with Anthem Blue Cross and Blue Shield in a Sept. 26 letter as the contract end date between the two organizations looms. “It is disappointing and deeply concerning…
On Sept. 25, Georgia Gov. Brian Kemp shared how CMS extended the state’s Pathways to Coverage program through 2026, despite a recent finding from the U.S. Government Accountability Office that the Medicaid work requirement program had spent over twice as…
CMS removed its enrollment sanction on eternalHealth on Sept. 10, according to a news release from the agency. In March, CMS suspended enrollment for eternalHealth’s Medicare Advantage-Prescription Drug Plan contracts after Massachusetts requested the insurer to cease marketing its products…