The Kansas Department of Administration rejected challenges to the state's Medicaid contract procurement process from Aetna and CareSource, the Kansas Reflector reported July 8.
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Medicare Advantage organizations are facing major challenges, including rising utilization rates, reduced reimbursements, and an evolving regulatory landscape.
To enhance its customer service, Blue Cross Blue Shield of Illinois is looking to artificial intelligence.
CareSource has named David Herndon as president of its North Carolina market.
Highmark has promoted Michael Edbauer, DO, to senior vice president of markets and named Jessica Cox as market president for Highmark Western and Northeastern New York.
UnitedHealth Group has named Ed Kaleta as senior vice president of external affairs.
Medicare Advantage plans received $50 billion in payments between 2018 and 2021 for "questionable diagnoses" insurers added to medical records, a Wall Street Journal investigation published July 8 has found.
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.
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: