Payer

Virginia Premier will move its 300,000 Medicaid members to Optima Health on July 1.

The Minnesota Department of Commerce alleges that HealthPartners violated mental health parity laws by analyzing claims for mental health and substance abuse treatment more stringently than other types of care. 

Best practices for state Medicaid programs during the unwinding of continuous coverage requirements include strong communications, a bolstered workforce and transparent data, according to AHIP. 

Oscar Health improved its year-over-year losses in the first three months of 2023. 

Oscar Health will exit the California individual ACA insurance market for plan year 2024 as part of a push to make its insurance business profitable. 

From Google Cloud launching an artificial intelligence-powered claims acceleration suite to CMS issuing a final rule to streaming the Medicare Advantage prior authorization process, here are eight prior authorization updates Becker's reported since April 6: 

Arkansas terminated Medicaid coverage for almost 73,000 people in April, including 44,667 people who had their eligibility extended during the COVID-19 public health emergency. 

Bright Health Group improved on its losses year over year and upped revenue in the first quarter of 2023. 

Medicare Advantage enrollment now represents half of total Medicare enrollment, according to a May 1 analysis from the Kaiser Family Foundation. 

Centene shareholders will vote on a pair of proposals that take aim at executive pay, the St. Louis Post-Dispatch reported May 9.