UnitedHealthcare is delaying a coverage policy that would have sharply restricted remote physiologic monitoring services for most chronic conditions. The policy, which had been scheduled to take effect Jan. 1, will now be implemented later next year, the insurer confirmed…
Author: Jakob Emerson
AHIP’s board of directors has elected Humana President and CEO Jim Rechtin as board chair effective Jan. 1. Mr. Rechtin succeeds Pat Geraghty, who announced his retirement after leading GuideWell and Florida Blue for 14 years. AHIP also named Patrick…
Humana’s Louisiana business received at least $10.5 million in Medicare Advantage overpayments in 2017 and 2018, according to an audit report from HHS’ Office of Inspector General. The audit, published in December, reviewed high-risk diagnosis codes including acute stroke, acute…
The Michigan Department of Health and Human Services is seeking bids from organizations interested in serving as the state’s pharmacy benefit administrator. The state’s pharmacy programs provide prescription drug coverage for Medicaid beneficiaries and related health programs, along with pharmacy…
A healthcare experience that offers an integrated, holistic approach is more critical than ever. It transcends traditional healthcare approaches by emphasizing the importance of putting the patient at the center and treating them as a whole person, rather than looking…
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Evry Health CEO and co-founder Chris Gay thinks the health insurance industry could eliminate prior authorizations entirely, but only if providers meet insurers halfway. On the Becker’s Payer Issues podcast, he spoke about the technology and business model problems fueling…
Commercial health insurance markets are continuing to become more concentrated, according to the AMA’s 2025 “Competition in health insurance” report published Dec. 16. The 24th annual report analyzed insurer market concentration across 384 metropolitan areas and all 50 states and…
Pittsburgh-based Highmark Health reported $24.6 billion in revenue, a $204 million operating loss, and a $69 million net loss in the first nine months of the year. Allegheny Health Network reported revenue of $4.2 billion during the period and an…
Humana’s insurance segment president, George Renaudin, will retire by the third quarter of 2026 following a nearly 30 year career at the company. He will serve as a strategic advisor to the company through at least the end of next…
Clever Care Health Plan is pairing its culturally competent care model with a new provider network partnership built around the lifestyle habits of the world’s longest-living populations. The partnership launches in 2026 and will connect Clever Care’s 40,000 Medicare Advantage…