Arizona Attorney General Kris Mayes accused healthcare data company MultiPlan, rebranded as Claritev, and eight health insurers of a price-fixing scheme. The complaint, filed in state court, alleged MultiPlan — along with Aetna, Cigna, UnitedHealth Group, Humana, Elevance Health, Health…
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AI agents are already processing prior authorizations, adjudicating claims and driving member outreach at scale. But an agent is only as trustworthy as the data grounding it. When member identities, benefits and authorizations are fragmented, agents make confident but wrong…
Presented by:
- Chris Pierpan
OR inefficiency doesn’t always look like downtime. It often hides in missed opportunities — unused blocks, delayed scheduling and reactive processes. At many health systems, released OR time becomes a quiet drain: lost revenue, surgeon frustration and underused capacity at…
Presented by:
- Kelly Connolly, MHSA, PMP
- Jane Yang, MHA
- Caity Butler, MSN, RN, CNOR
- Thomas Brehmer
As health systems face ongoing margin pressure and limited capital, leaders are being asked to deliver faster, more strategic insights around budgeting, forecasting and enterprise performance. But siloed systems and manual reporting continue to slow progress. In a recent Becker’s…
Presented by:
Safety-net hospitals operate under extraordinary pressure. The ones making progress are finding new ways forward through strategy and innovation. This webinar brings together executive leaders working with the nation’s private safety-net hospitals to share how deliberate strategy around service line…
Presented by:
- Sameer Shah, PharmD, MHA, CSSBB, FACHE
- Scott Wester
- Brandon Newman, PharmD
- Allison Arant
Blue Cross and Blue Shield of Illinois is expanding maternal health coverage to include doulas, licensed certified professional midwives, lactation consultants and maternal home visit providers. This development applies to all lines of business, including Medicaid, the insurer confirmed to…
Longitude Health has named Colin Drylie COO of Longitude FX, a member-owned agentic utility aimed at advancing shared services from patient access to revenue cycle and back-office functions. In his new role, Mr. Drylie will oversee platform operations for Longitude…
CMS is suspending enrollment for a Maryland Medicare Advantage institutional special needs plan operated by Provider Partners Health Plans after the insurer lost all contracted long-term care facilities in the plan’s network and then disenrolled some members without their consent.…
Mario Schlosser, Oscar Health’s co-founder and chief technology officer, has transitioned to serve as an advisor to CEO Mark Bertolini. Oscar and Mr. Schlosser entered the revised agreement May 29, effective June 1, according to a company filing. In the…
The HHS Office of the Inspector General estimates $462 million in CMS overpayments to Medicare Advantage plans stemming from some unsupported acute stroke diagnosis codes. In a May report, the OIG reviewed a sample of 97 MA beneficiaries. The entire…
