As insurance premiums continue to rise nationwide, lawsuits from large, self-insured employers are being filed against health insurers in an effort to access complete medical claims data and fulfill fiduciary duties under federal law.
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Audits from HHS' Office of Inspector General published in the first half of 2023 found over $56 million in estimated overpayments to Medicare Advantage providers.
As of July 19, more than 3 million people have been disenrolled from Medicaid during the unwinding of the Medicaid continuous enrollment provision, according to KFF.
Community Health Plan of Washington named Demetria Malloy, MD, its chief health officer and chief medical officer.
A new bill filed in the Senate July 20 aims to lift the ban on Medicare coverage of weight loss drugs such as Ozempic and Wegovy.
CMS has approved proposals from California and Kentucky for community-based mobile intervention teams to provide behavioral crisis services to Medicaid enrollees.
UnitedHealth Group recently announced that Neil de Crescenzo departed his role as CEO of Optum Insight and was replaced by Roger Connor. In addition to that role, Mr. Connor is continuing to serve as executive vice president of enterprise operations…
Expensive GLP-1 drugs are just one of many factors driving up medical costs, Elevance Health CFO John Gallina said.
Elevance Health is scaling new uses for artificial intelligence.
Molina Healthcare had the highest overall prior authorization denial rates in 2019 among the seven largest Medicaid managed care organizations, according to an audit from HHS' Office of Inspector General.