The Latest

Aetna is rolling out new claims cost control measures under its Claim and Code Review Program, beginning Sept. 1. The new claims editing policy applies to commercial, Medicare and student health members, the company said in June. Aetna may trigger…

Economic uncertainty and policy changes from the current administration have changed the way health plans operate over the past year. Many have found workarounds to continue efficiency and growth. Becker’s connected with five leaders to learn their biggest accomplishments so far…

MVP Health Plan has agreed to overhaul its mental health provider directory as part of a settlement with the New York Attorney General’s Office.  The settlement follows an investigation from the office that uncovered systemic issues with MVP’s network, including…

Massachusetts has approved $75.6 million in health insurance rebates for more than 350,000 residents and small businesses. The rebates are required under the state’s medical loss ratio law, which mandates that insurers spend at least 88% of premiums on medical…

The Justice Department has expanded its criminal investigation into UnitedHealth Group, examining the company’s pharmacy benefit manager, Optum Rx, and how it compensates its employed physicians, Bloomberg reported Aug. 26.  The probe now goes beyond the previously reported potential Medicare…