UnitedHealthcare has at least 75% of the Medicare Advantage market in three cities, according to the American Medical Association.
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From CareFirst suing Johnson & Johnson over alleged anticompetitive biosimilar tactics to Humana accused of using an AI tool to wrongfully deny Medicare Advantage claims, here five lawsuits, settlements and legal developments involving payers that Becker's has reported since Dec.…
HHS urged nine states to do more to keep eligible children enrolled in Medicaid, and more states are considering Medicaid work requirements.
Payers are implementing artificial intelligence to detect fraud, speed up prior authorization and assist members' care.
Starting Jan. 1, California will become the first state to offer Medicaid coverage to all eligible undocumented individuals, Cal Matters reported Dec. 28.
In 2023, Humana announced plans to end its commercial insurance business, named its next CEO and saw a planned merger with Cigna fall through.
A pair of senators are asking CMS to require Medicare Advantage plans to cover stays in long-term care facilities at the same rate as traditional Medicare.
Clover Health has named Terrence Ronan as interim CFO, effective Jan. 27.
New York City-based Mount Sinai Health System could go out of network with UnitedHealthcare on Jan. 1 if the two sides are unable to reach a new contract.
Blue Cross Blue Shield of Arizona has tapped Maricopa County Sheriff Paul Penzone for a vice president role overseeing the payer's community programs and charitable giving, CBS 5 reported Dec. 14.