Anthem Blue Cross of California is extending the pause on its upcoming evaluation and management claim downcoding policy until at least May 1, the insurer confirmed to Becker’s March 31. The California Medical Association said the policy is pending review…
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Cost Plus Drugs’ Mark Cuban recently voiced his support for the “Break Up Big Medicine Act,” introduced by Sens. Elizabeth Warren, D-Mass., and Josh Hawley, R-Mo. Proposed in February, the bill would prevent companies from simultaneously owning a health insurer…
A trustee of Dallas-based Steward Health Care is suing Aetna to recover $6.36 million the carrier allegedly owes, according to a March 27 lawsuit filed in the Houston division of the southern district of Texas U.S. bankruptcy court. In the…
Improving the member experience is a top priority for leading health plans, yet friction across payments, regulatory compliance and system integration continues to stand in the way. The most effective approach: methodically evaluate each stage of the member journey and…
Managing lab operations across a large dental organization can create complexity that limits visibility, increases costs and makes growth harder to sustain. This case study explores how Apex Dental Partners moved from managing more than 100 disparate lab relationships to…
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CareFirst BlueCross BlueShield has named Kurt Small as its next president and CEO, effective May 4. Mr. Small currently serves as president of Medicaid at Elevance Health and previously held executive leadership roles at BCBS Minnesota, Highmark and Aetna. CareFirst’s…
Elevance Health has made six senior leadership appointments across its health benefits and Carelon businesses. 1. Aimée Dailey has been named president of government business, with responsibility for Medicare, Medicaid, federal government products, and group retiree plans. She previously served…
Pomona Valley Hospital Medical Center, a 427-bed community medical center, faced a multi-month surgical backlog — compounded by fragmented scheduling, manual workflows and poor communication across facilities. It was a significant operational challenge with no easy fix. But in 90…
May 14, 2026 1:00 PM - 2:00 PM CDT
Presented by:
Presenters:
- Martha Soto, MSN, RN, CNOR, Director of Perioperative Services, Nursing Administration Pomona Valley Hospital Medical Center
- Maria J. Cortez, DPA, RN, Nurse Manager, Surgery - Outpatient Pavilion Pomona Valley Hospital Medical Center
- Kaylie Firebaugh, Client Outcomes Specialist LeanTaaS
CVS Caremark and the Blue Cross Blue Shield Association overcharged the Federal Employees Health Benefits Program by a total of $615 million in pharmacy pricing between 2018 and 2021, according to a final audit report published by the Office of…
This month, Alabama enacted HB300, a law that requires health plans to cover breast exams without a deductible, copay or coinsurance. Diagnostic breast exams include mammography, MRIs, ultrasounds and molecular imaging used for detecting and understanding abnormalities. Health plans must…