Fort Myers, Fla.-based Lee Health said it would terminate hospital and physician contracts with UnitedHealthcare at the end of 2026. Beginning Jan. 1, 2027, Lee Health will be out of network for UnitedHealthcare employer-based, individual and Medicare Advantage plan members.…
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The California Legislature has passed a California Medical Association-backed bill that extends the validity of approved prior authorizations to one year, and the bill now heads to Gov. Gavin Newsom’s desk. The bill requires health plans and insurers to honor…
Maryland Attorney General Anthony Brown has filed a lawsuit against UnitedHealth Group and Optum, seeking $380 million in damages stemming from alleged issues administering a Medicaid behavioral health program. “Marylanders in crisis and the providers who care for them rely…
Amid an industry landscape where the largest insurers have spent years diversifying their portfolios, one regional payer is betting that the current wave of financial disruption is presenting an opportunity to grow. WPS Health Solutions, an 80-year-old nonprofit insurer headquartered…
Medi-Cal enrollment decreased by 730,000 members from June 2025 to March 2026. The data came from the California Department of Health Care Services. A July analysis from California Health Care Foundation Senior Program Officer Diana Camacho said overall Medi-Cal enrollment…
The ROI of Unification: Why Smart Organizations Are Shifting to End-to-End RCM—And How Yours Can Too
Efficiency is the key to unlocking yield that can be reinvested into your organization and patient outcomes. But with separate revenue cycle solutions, even if they’re successful on their own, efficiencies can’t be maximized—and neither can your yield. In this…
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Picture a system where at-risk patients are flagged for early intervention, where primary care has the tools to act, and where coordinated, multidisciplinary care is delivered at scale. For most organizations, that picture is blocked by fragmented care and siloed…
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Frank Caporusso will serve as COO of Blue Shield of California, effective Sept. 1. According to an Aug. 27 news release, the company reconfigured its COO role. Mr. Caporusso will lead enterprise-wide operations, collaborate with the executive leadership team on…
A state grand jury determined that $10 million from a Centene Medicaid settlement was “misappropriated” under Florida Republican Gov. Ron DeSantis’ administration, according to a Jan. 28 sealed document obtained by CBS News Miami. Despite the findings, the document said…
Mona Chitre, PharmD, will serve as the market president for the newly created employer and government markets segment under Optum Rx, UnitedHealth Group’s pharmacy benefit manager. Dr. Chitre will begin her role Aug. 31, according to an Aug. 26 LinkedIn…