Groups representing insurers are pushing back on proposed tighter regulations on Medicare Advantage coding. Senate Republicans are considering targeted changes to Medicare Advantage as part of the sweeping “One Big Beautiful Bill.” Lawmakers are considering adding provisions of the No…
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Digital tools with a human touch — 4 takeaways on Magellan Health’s partnership with Calm Health
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During a featured session at Becker’s Spring Payer Issues Roundtable in April, leaders from Calm Health and behavioral health provider Magellan Health shared a blueprint for marrying clinical rigor with digital engagement to expand access to behavioral healthcare. Chris Mosunic,…
The investment arm of Marietta, Ga.-based Wellstar Health System, Catalyst by Wellstar, has invested in Venteur, a digital health startup that administers Individual Coverage Health Reimbursement Arrangement plans. ICHRAs allow employers to contribute tax-free dollars to employees’ health benefits, which…
Moody’s Ratings has downgraded UnitedHealth Group’s outlook from stable to negative, citing “a number of adverse trends simultaneously.” The ratings agency also affirmed the company’s strong credit ratings, including its long-term issuer and senior unsecured debt ratings, as well as…
Coventry Health and Life Insurance Co., an Aetna subsidiary, received an estimated $6.9 million in Medicare Advantage overpayments, an audit published by HHS’ Office of Inspector General June 5 found. The government watchdog reviewed a sample of diagnosis codes Coventry…
Long Beach, Calif.-based Molina Healthcare will lay off 268 employees in Virginia, according to a WARN notice filed May 13. The company is closing its Richmond, Va., office effective June 30. The layoffs come after Virginia decided not to renew…
Cigna and Pittsburgh-based Allegheny Health Network will be out of network on July 1 without a new contract in place, the Pittsburgh Business Times reported. According to the report, about 20,000 Cigna members have used an AHN provider within the…
Transforming kidney care: A population health approach to improving outcomes and cutting costs
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In a featured session at Becker’s 15th Annual Meeting, Joe Vattamattam, co-founder and president of Healthmap Solutions, presented a data-driven case for value-based kidney care. He emphasized the urgent need for earlier intervention, integrated support, and smarter use of AI…
Seventeen percent of initial Medicare Advantage claims are denied, but 57% of originally denied claims are ultimately overturned, according to a study published June 2 in Health Affairs. The study analyzed 270 million claims from 2019 based on data from…
Reps. Alexandria Ocasio-Cortez and Lloyd Doggett have asked U.S. Attorney General Pam Bondi to expand the Justice Department’s reported civil and criminal investigations into UnitedHealth Group to include allegations that the company has engaged in harmful and fraudulent cost-cutting tactics…