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5 payers with co-branded Medicare Advantage plans
Co-branded Medicare Advantage plans shared between two organizations are nothing new, but payers continue to dive into new partnerships in an effort to reach more niche populations across a variety of settings. -
Lawmaker launching investigation into Medicaid prior authorization denials
U.S. Rep. Frank Pallone Jr. is launching an inquiry into prior authorization denials by Medicaid managed care organizations. -
Medicaid in the headlines: 10 recent updates
CMS warned states about their compliance with Medicaid redetermination guidelines, and Medicaid expansion in North Carolina is hitting roadblocks. -
Blue Shield of California shrugs CVS for Mark Cuban, Amazon pharmacies
Blue Shield of California chose Mark Cuban Cost Plus Drug Co. and Amazon Pharmacy on Aug. 17 as its preferred pharmacy networks. -
Another House bill takes aim at prior authorizations
Tennessee Rep. Mark Green has introduced a bill targeting prior authorization requirements in Medicare and Medicare Advantage, as well as prior authorization fixes for Medicare prescription drug plans. -
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.
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