Centene posted $738 million in net income during the third quarter and awarded Cigna's Express Scripts a PBM contract, according to the company's earnings report released Oct. 25.
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Humana is reportedly exiting the Colorado group insurance market, Colorado Politics reported Oct. 24.
Pennsylvania lawmakers are considering a bill that supporters say will streamline the prior authorization process, CBS affiliate WHP reported Oct. 24.
The Transparency in Coverage (TiC) final rule went into effect July 1, 2022, and requires insurers to include provider-negotiated rates, as well as allowed billable amounts for all out-of-network providers.
Payers are expanding Medicare Advantage plans to new markets for 2023, and many are facing increased scrutiny and legal action for overpayments.
Navigation difficulties were cited as the top reason beneficiaries switched their health insurance plans, according to an Oct. 18 report from the professional services company Accenture.
Humana and Boston-based Cohere Health are expanding their partnership again to enable a digitized prior authorization process nationwide for cardiovascular and surgical services.
About a third, or 31.6 percent, of the 57 Medicare Advantage plans that earned five stars from CMS in 2023 are a part of the Alliance of Community Health Plans, a trade group representing nonprofit payers.
Elevance Health has expanded its home-based nursing management company, myNEXUS, to Medicare Advantage members in 15 states, CEO Gail Boudreaux said Oct. 19 during a call with investors.
As North Carolina shifts its Medicaid system to managed care, Duke University Margolis Center for Health Policy researchers recommend the state integrates care for dual-eligible beneficiaries to the most comprehensive level possible.