Managed care organization Magellan Health, part of Centene, has appointed Steven Pratt, MD, as chief medical officer, according to a Sept. 10 news release. Dr. Pratt, a psychiatrist, will further the company’s clinical mission and engagement in his new role.…
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Amid a wave of health systems dropping Medicare Advantage plans over administrative and reimbursement issues, the Medicare Payment Advisory Commission has found no “statistically significant change in hospital profit margins” due to growing enrollment in Medicare Advantage plans, according to…
An estimated 450,000 New Yorkers will lose zero-premium comprehensive health insurance amid the One Big Beautiful Bill Act’s cuts, according to a news release from the New York State Department of Health and a statement from Democratic Gov. Kathy Hochul.…
A federal judge in Minnesota has denied UnitedHealth Group’s request to narrow the scope of discovery in an ongoing lawsuit that accuses the insurer of using artificial intelligence to wrongfully deny Medicare Advantage members post-acute care. The case, filed in…
CVS Caremark will pay $32.1 million to the state of Oklahoma after the pharmacy benefit manager allegedly held back savings from the state’s employee health plan, according to a Sept. 9 news release from Oklahoma Attorney General Gentner Drummond. The…
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UnitedHealth’s Rocky Mountain HMO and Elevance Health’s Anthem HMO Colorado have withdrawn their plans to end coverage for multiple health plans in the state’s individual market following legislative action in the Colorado General Assembly. Both companies will continue services in…
Patients’ high demand for behavioral health services since the pandemic is no secret, but Bill Harlan — vice president of behavioral health and health engagement of Canton, Mass.-based Point32Health — said the insurer’s provider partners have also faced challenges, like…
With its second Program of All-Inclusive Care for the Elderly center now open in South Los Angeles, SCAN Group is pressing ahead with a care model that faces steep regulatory challenges. The new 33,000-square-foot facility in Compton will provide low…
CMS is delaying a Medicare Advantage supplement benefits notification rule that was slated to start in 2026. The pause affects MA organizations that would have sent annual notifications between June 30 and July 31 to enrollees about unused benefits, according…
GLP-1 costs have stayed nearly flat in recent years when accounting for rebates, according to an analysis from the Delaware Department of Insurance’s Office of Value-Based Health Care Delivery. Based on this finding, Trinidad Navarro, the state’s insurance commissioner, questioned…