Author: Rylee Wilson

The American Medical Association is raising concerns about the use of artificial intelligence to review claims for prior authorization. 

Just two states — Florida and Montana — have not taken up any temporary waivers from CMS designed to simplify Medicaid renewals. 

Medicaid disenrollments will drive a total decrease in spending in 2024, even as spending per beneficiary is set to increase, according to new CMS data. 

Aetna is seeking to intervene in a lawsuit filed by retired New York City employees seeking to block the payer's Medicare Advantage contract with the city from taking effect. 

UnitedHealthcare is seeing rising utilization as more older adults seek out services they delayed during the COVID-19 pandemic, Barron's reported June 14. 

Empire BlueCross BlueShield and Empire Blue Cross will rebrand as Anthem Blue Cross Blue Shield and Anthem Blue Cross in 2024. 

An AI-powered model improved maternal health outcomes for Molina Healthcare members. 

CMS officials are urging states to double-down on efforts to prevent people from unnecessarily losing Medicaid coverage. 

Medicare Advantage plan enrollees have lower expenses than those with similar risk scores who remain in traditional Medicare, but payments to the program are based on traditional Medicare, according to a whitepaper from researchers at the University of Southern California…

Prior authorization changes and paperless policies led UnitedHealth Group to cut its paper usage by 1 billion pieces, according to the company's sustainability report.