The Massachusetts Laborers' Health and Welfare Benefit Fund is suing Blue Cross Blue Shield of Massachusetts again for allegedly overcharging for healthcare and administrative services as the fund's third-party administrator.
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Lawmakers are launching an investigation into the largest Medicaid managed care organizations over prior authorization denial rates.
Cincinnati-based Bon Secours Mercy Health and Anthem Blue Cross and Blue Shield have reached a contract agreement through 2028, ending one of the more public payer-provider reimbursement disputes of this year.
The shift from Medicaid coverage to individual exchange coverage is not going as planned, The Washington Post reported Sept. 28.
Elevance Health has paused a major acquisition and alleged one of its former executives could expose trade secrets to rival Molina Healthcare.
The CMS innovation center tasked with creating innovative payment models cost the government more money than it saved in its first decade, a report from the Congressional Budget Office found.
The U.K.'s Competition and Markets Authority has given UnitedHealth the OK to acquire health technology firm EMIS Group.
UCare has selected Navitus Health Solutions, a pharmacy benefit manager owned by St. Louis-based SSM Health and Costco, to administer pharmacy benefits to its more than 600,000 members across all lines of business, effective Jan. 1.
Among the major payers, customers are most satisfied with the telehealth offerings from UnitedHealthcare and Kaiser Permanente, according to the "J.D. Power 2023 U.S. Telehealth Satisfaction Study."
New Hampshire is looking for payers to administer its Medicaid managed care program starting next year.