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…
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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…
Medicare open enrollment kicked off earlier this month and will run until Dec. 7. From some big players exiting Medicare Advantage to boosts in regulatory legislation, there has been more uncertainty with navigating the space. Becker’s caught up with six…
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Oscar Health is launching an AI agent and a menopause health program in 2026, according to an Oct. 20 news release. OpenAI will power AI agent Oswell, providing on-demand support for members and patient data insights for providers. Oscar said…
The Cigna Group and CVS Health said they will offer discounted infertility medications through TrumpRx, beginning in January 2026. Cigna’s Evernorth pharmacies — Freedom Fertility and VFP Pharmacy Group — plan to dispense EMD Serono’s Gonal-f, Cetrotide and Ovidrel at…
Trillium Community Health Plan, a Centene subsidiary, will take over PacificSource’s Medicaid population in Oregon’s Lane County, according to statements shared with Becker’s Oct. 17. In September, PacificSource decided not to renew its Medicaid contract, affecting about 92,000 people in…
CMS Administrator Mehmet Oz, MD, discussed some of the biggest issues facing the Medicare Advantage program at an Oct. 15 industry conference. During his first six months on the job, CMS has already overseen policy moves to streamline prior authorization…
Following the kickoff of Medicare open enrollment on Oct. 15, The Washington Post discovered inconsistencies in the Medicare Plan Finder, such as duplicative addresses and contradictory information regarding providers’ network status. After the Post reported the issues to CMS, an…