Author: Staff

An audit from the HHS Office of Inspector General found that several of UPMC health plan's high-risk diagnosis codes did not meet federal standards, resulting in $6.4 million in overpayments from 2015 to 2016.

Over 46,000 South Dakota residents signed and submitted a petition to vote on expanding the state's Medicaid program. 

More providers are opting to use risk-based Medicare Advantage models, with nearly 60 percent of health systems now preferring them, according to an analysis from Guidehouse. 

A class-action lawsuit filed Nov. 4 is accusing United Behavioral Health, a branch of UnitedHealthcare, of unjustly denying mental health claims.  

WellCare announced its 2022 special supplemental benefits for people with chronic illnesses, which feature perks ranging from flexible in-home support to a robotic pet. 

Centene subsidiary WellCare announced an agreement with Orange, Calif.-based Prospect Medical that brings its San Antonio, Texas, area providers in network.

Blue Cross and Blue Shield of North Carolina is keeping its telehealth coverage policy after witnessing a 7,500 percent increase in its utilization in 2020. 

Lake Forest, Ill.-based Trustmark Health Benefits is offering a virtual-first health plan through a collaboration with Teladoc Health.

As UnitedHealthcare and Greenville, S.C.-based Prisma Health continue to spar over renewing contracts, the parties' accounts of the negotiation process are also divided.

GuideWell cut the ribbon on a new facility that blends both its insurance and primary care ventures.