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7 payers expanding to new markets
Payers are planning moves to new markets in 2024. -
Evernorth's advice to payers on managing costly cancer drugs
Immune checkpoint inhibitors, first launched in 2011, have greatly improved survival rates for melanoma, kidney and lung cancers. -
Connecticut attorney general latest to object to insurers' rate hike proposals
Connecticut Attorney General William Tong sent a letter to the state's insurance commissioner asking him to reject double-digit rate increases sought by Anthem, Cigna and ConnectiCare. -
Amedisys filed misleading statement regarding UnitedHealth acquisition, lawsuit alleges
An Amedisys stockholder has filed a lawsuit against the home health provider and its directors, alleging they misrepresented key information in a proxy statement related to UnitedHealth's proposed acquisition of the company. -
Georgia approves 265 individuals for Medicaid work requirements in program's first month
Georgia has approved 265 people to take part in the nation's only Medicaid program that requires proof of work to receive benefits, the Georgia Recorder reported Aug. 10. -
Medicaid termination numbers aren't the full picture, some state directors say
Some state officials say people who have lost Medicaid coverage during the redeterminations process are not all becoming uninsured, Politico reported Aug. 15. -
UnitedHealth puts $2.9M behind Indiana home health workers
UnitedHealthcare is giving $2.85 million to four Indiana organizations supporting direct service health workers. -
Aetna in the headlines: 7 recent updates
Aetna is facing the latest legal setback to its Medicare Advantage contract to provide coverage to retired New York City employees, and parent company CVS Health is implementing layoffs and restructuring as revenues decline. -
16 states with excessive Medicaid application processing times, per CMS
Over a dozen states fell behind processing Medicaid applications in May as they redetermined the eligibility of existing members, according to CMS. -
Redeterminations could put Florida Medicaid in financial trouble
Florida's Medicaid program could be facing a financial shortfall, as more residents than the state predicted have remained on the program through the redetermination process, Florida Politics reported Aug. 14. -
Pennsylvania considers requiring insurers to disclose how they use AI
A group of Pennsylvania lawmakers is introducing legislation to require payers' to disclose how they use AI in claims review and require human review of any AI-processed claims. -
27 states with concerning rates of procedural Medicaid terminations, per CMS
CMS warned 36 states they were not meeting federal requirements for Medicaid call center wait times, application processing timelines and rates of procedural terminations. -
OIG: Presbyterian Health Plan received estimated $2.2M in Medicare Advantage overpayments
Presbyterian Health Plan received an estimated $2.2 million in Medicare Advantage payments in 2017 and 2018, according to an audit from HHS' Office of the Inspector General. -
Molina Healthcare in the headlines: 10 updates
From posting 24.6 percent net income growth in the second quarter, to projecting adding $1.8 billion in premium revenue from its acquisition of Bright Health's Medicare Advantage business, here are 10 updates on Molina Healthcare that Becker's has reported since June 30: -
Why an Oregon health system wants its patients to avoid Medicare Advantage
Bend, Ore.-based St. Charles Health System is considering dropping all Medicare Advantage plans and is encouraging its senior patients not to enroll in the private Medicare plans during the next open enrollment period. -
Judge blocks $15B Aetna Medicare Advantage contract for NYC retirees
A New York State Supreme Court judge has permanently blocked the implementation of New York City's plan to switch 250,000 retired city employees from traditional Medicare to an Aetna Medicare Advantage plan. -
Layoffs hit Optum
Former employees with UnitedHealth Group's Optum and its subsidiaries have taken to social media in August regarding an unknown number of layoffs they say are occurring across the company. -
Medicare Advantage in the headlines: 10 recent updates
Medicare Advantage plans are set to receive $12.8 billion in bonus payments from CMS in 2023, and representatives are introducing new legislation aimed at reforming prior authorization in the program. -
House bill aims to alleviate Medicaid staffing shortages during redeterminations
A House bill has been introduced that aims to alleviate staffing shortage at state Medicaid agencies so beneficiaries do not lose coverage due to procedural issues during the redetermination process. -
6 prior authorization updates
From lawmakers unveiling gold-card legislation to UnitedHealthcare detailing plans to cut 20 percent of requirements, here are six prior authorization updates Becker's has reported since July 26:
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