Oklahoma Attorney General Gentner Drummond challenged the state’s managed care Medicaid in an Oct. 22 letter to the Oklahoma Health Care Authority, the agency that oversees the program. Mr. Drummond said providers have concerns about pediatric patient care, such as…
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James Brown, Montana state auditor and commissioner of securities and insurance, launched an investigation into Blue Cross and Blue Shield of Montana, a subsidiary of Health Care Service Corp., after a data breach that may have affected up to 462,000…
CMS Administrator Mehmet Oz, MD, told FOX 5 Atlanta that the government shutdown is not affecting Medicare open enrollment. “The shutdown is a problem for lots of parts of government but not for [Medicare] open enrollment,” he said. “Medicare is…
While best known for our healthcare technology, InterSystems is a global leader in interoperability across multiple industries. One goal common to all of them is achieving the level data liquidity needed to unlock simultaneous breakthroughs in quality and efficiency. However,…
SCAN Health Plan and Costco Wholesale Corp., a preferred pharmacy for the insurer, are collaborating to offer older adults a rewards program, provide them with greater flexibility with spending benefits and educate them about Medicare. Senthu Arumugam, SCAN’s chief commercial…
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Johnson City, Tenn.-based Ballad Health is suing UnitedHealth Group for alleged “Medicare Advantage manipulation” that has led to denied care and underpayment for services. The lawsuit was filed Oct. 21 in a Tennessee federal court and claims that UnitedHealth’s actions…
Elevance Health is working to mitigate rising costs in its Medicaid business amid what executives describe as a challenging year ahead. The company reported its third-quarter earnings on Oct. 21, with senior leadership telling investors that escalating Medicaid costs, driven…
UnitedHealth’s Optum has launched Optum Real, a real-time claims system designed to streamline the claims and reimbursement process by providing instant coverage validation for providers. “Optum Real transforms the pre-service experience in real time by delivering greater clarity and certainty…
A Colorado state audit criticized Connect for Health, a nonprofit organization that runs the state’s health insurance marketplace, for its sponsorship practices, financial management and reporting in a Sept. 16 report. The state’s General Assembly requested the audit following Connect…
Monongalia County, West Virginia is dropping group coverage from Highmark Blue Cross Blue Shield in favor of Individual Coverage Health Reimbursement Arrangements administered by Take Command, local outlet WAJR reported Oct. 20. Premiums will continue to be almost entirely covered…