Payer

Centene CEO Sarah London foresees major disruption opportunities ahead in the employer group insurance market by way of individual marketplace coverage.

Humana used an artificial intelligence tool owned by UnitedHealth Group to wrongfully deny Medicare Advantage members' medical claims, according to a class-action complaint filed Dec. 12.

Ten providers recently posted job listings seeking leaders in payer contracting and relations.

From its Optum arm adding nearly 20,000 physicians in 2023 to outlining its 2024 revenue expectations, here are 12 updates on UnitedHealth Group that Becker's has reported since Nov. 27: 

Centene expects 2024 revenues to be at least $142.5 billion

A settlement agreement with South Carolina in late December brought the total amount that Centene paid in 2023 to resolve allegations it overbilled state Medicaid programs for pharmacy services to $307 million. 

Humana has disbanded its executive committee, according to a Dec. 7 regulatory filing from the company. 

Groups advocating on behalf of older adults and people with disabilities are asking federal agencies for a "full-scale investigation" following what they say are misleading Medicare Advantage advertising practices by UnitedHealthcare.

North Carolina officially implemented Medicaid expansion, and CMS laid out plans to crack down on states violating federal laws around Medicaid redeterminations. 

Here are seven prior authorization updates Becker's has reported since Nov. 6: