CMS is proposing new health equity changes for prior authorization policies and procedures at Medicare Advantage organizations to better determine any disproportionate impact on underserved populations that may delay or deny access to services.
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A group of federal lawmakers is asking CMS to increase its oversight of artificial intelligence and algorithms used in Medicare Advantage prior authorization decisions.
The Illinois Department of Insurance has fined Health Care Service Corp., the parent company of Blue Cross Blue Shield of Illinois, nearly $1.2 million in less than two years for violating the state's Network Adequacy and Transparency Act, which requires…
Increasing Medicare Advantage enrollment in rural areas did not increase rural hospitals' financial distress or risk of closing, a study published Nov. 3 in the American Journal of Managed Care found.
The Cigna Group is exploring a potential sale of its Medicare Advantage business, Reuters exclusively reported Nov. 6.
Blue Cross Blue Shield of Massachusetts is removing 14,000 prior authorization requirements for home care services for its 2.6 million commercial members beginning Jan. 1.
Providence Health Plan has added three new executives to its finance team, according to a Nov. 1 news release.
Payer leaders are turning their attention to health equity, prior authorization, AI and more as 2024 approaches.
Allstate is looking to sell its health benefits division in 2024, CEO Tom Wilson told investors on a Nov. 2 quarterly earnings call.
UnitedHealth Group has named Charlie Baker to its board of directors.