The Latest

Oklahoma Attorney General Gentner Drummond challenged the state’s managed care Medicaid in an Oct. 22 letter to the Oklahoma Health Care Authority, the agency that oversees the program. Mr. Drummond said providers have concerns about pediatric patient care, such as…

Blue Cross Blue Shield of Massachusetts is expanding its claims review process to address what it is describing as potential overcoding among physicians who routinely bill for high-complexity visits. The new policy takes effect for dates of service on or…

Elevance Health has shared plans to potentially penalize hospitals and other contracted facilities that use care providers who are not in-network with its Anthem Blue Cross Blue Shield commercial plans in 11 states. Under the policy, finalized Oct. 1 and…

Optum has named Ben Eklo as its next chief financial officer, effective Nov. 1.  Mr. Eklo has been with the company for 18 years, a spokesperson for UnitedHealth Group told Becker’s. He replaces Roger Connor, who was named CFO of…

James Brown, Montana state auditor and commissioner of securities and insurance, launched an investigation into Blue Cross and Blue Shield of Montana, a subsidiary of Health Care Service Corp., after a data breach that may have affected up to 462,000…

Coverage for drugs recently approved by the FDA can take months to solidify, according to the Institute for Clinical and Economic Review’s “Launch Price and Access Report,” published Oct. 23. Researchers reviewed 24 drugs from Boston-based Tufts Medical Center’s specialty…

Molina Healthcare reported a 72% decline in net income for the third quarter and has reduced its adjusted annual earnings guidance for the third time this year to $14 a share as the company faces rising costs in its marketplace…