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CMS is stepping up efforts to audit Medicare Advantage plans, and federal lawmakers are reintroducing legislation aimed at simplifying prior…
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CMS is stepping up efforts to audit Medicare Advantage plans, and federal lawmakers are reintroducing legislation aimed at simplifying prior authorization in the program. Here are seven Medicare Advantage updates Becker’s has reported since May 12:
Blue Cross Blue Shield of Minnesota will offer access to specialty behavioral care through partnerships with Equip and Pelago. Equip provides fully virtual care for eating disorders, according to a May 22 news release. Pelago offers virtual treatment for opioid…
Santa Clara Family Health Plan is pushing back against Santa Clara County’s move to transition its Medi-Cal infrastructure to a “single plan” model, calling the move a “hostile takeover,” the Mercury News reported May 22. Santa Clara Family Health Plan…
Cincinnati-based Bon Secours providers and facilities in South Carolina are facing a network split with UnitedHealthcare. If an agreement is not reached before July 1, the two organizations will be out-of-network across commercial, ACA, Medicare Advantage, and veteran plans. Some…
Hospitals and medical practices faced slower payment processing from insurers in 2024 compared to 2023 even as prior authorization denial rates fell, according to new revenue cycle data from Kodiak Solutions. The data was derived from more than 2,100 hospitals…
The trade group representing insurers is warning budget legislation could lead to ‘unprecedented’ coverage losses. In a May 22 statement, AHIP President Mike Tuffin said that proposed budget legislation would increase uninsured rates and could raise premiums in the individual…
UnitedHealth Group’s former CEO Andrew Witty has resigned from the company’s board of directors, effective immediately. Mr. Witty will not stand for re-election as a director during the company’s annual shareholder meeting scheduled for June 2, the company said in…
Urbana, Ill.-based Carle Health will shut down its insurance businesses at the end of 2025. In a statement shared with Becker’s on May 22, Carle Health said Health Alliance and FirstCarolinaCare will exit all lines of business, including Medicare Advantage,…
Aetna Better Health of Illinois paid $20.4 million in value-based incentive payments to 16 community health centers. The funding is intended to improve quality of care in underserved communities, according to a May 20 news release. Three things to know: …
In a reversal, Colorado will continue to cover GLP-1s for state employees who already have prescriptions, the Colorado Sun reported May 20. Copays for those individuals will increase from $30 to $120 in July, and the state’s health plan will…