Author: Rylee Wilson

Insurers denied around 17 percent of in-network claims for ACA Exchange plans in 2021, according to an analysis from Kaiser Family Foundation. 

Centene will pay California $215 million, the largest payment the company has made to settle allegations it overcharged state Medicaid programs. 

Payer executives are still taking stock of tougher Medicare Advantage auditing standards CMS unveiled Jan. 31.  

SCAN Health Plan has named Michael Blea as chief growth officer. 

Humana has entered a five-year agreement with ChenMed to provide in-network services to Humana Medicare Advantage members. 

Elevance Health CEO Gail Boudreaux has been elected to chair the Business Council, becoming the first woman to lead the association of top CEOs in its 90-year history. 

The three payers competing for North Carolina's state health plan contract submitted very similar bids, but Aetna ultimately won out based on a higher score for its administrative services, according to new documents released by the North Carolina State Treasurer's…

Aetna has been awarded a contract to continue managing West Virginia's Medicaid services for children in the foster care system. 

Centene grew its revenue 15 percent over the past year but lost $213 million in the last three months of 2022. The payer also settled overbilling allegations in another state and divested Magellan Specialty Health. 

Molina Healthcare is establishing a 24-hour mental health crisis hotline in Florida.