A North Carolina state court has sided with the state in its decision to award Aetna its health plan contract for public employees over Blue Cross Blue Shield of North Carolina.
The Latest
Payers have faced state penalties over the last year for slow reimbursements, improper claims denials, or the sale of unapproved products.
Here are five updates on prior authorization, Becker's has reported since June 18:
Forty organizations received revised star ratings from CMS after the agency recalculated its star ratings for 2024.
A federal judge has paused implementation of CMS regulations capping the amount Medicare Advantage companies can pay brokers that sell their plans.
HHS' Office of Inspector General will audit Medicare Advantage plans' use of prior authorization in post-acute care settings.
CMS has approved requests from five states to provide Medicaid coverage to incarcerated people before they are released.
A group of 24 lawmakers expressed concern Express Scripts could be limiting Tricare beneficiaries' choice of pharmacies.
Texas has fined Cigna $600,000 for failing to comply with multiple independent claims dispute resolution requirements under state law.
In 2023, gross margins per member were highest in the Medicare Advantage market, and medical loss ratios were lowest in the individual market, according to a July 2 analysis from KFF.