Five states represent the majority of where No Surprises Act disputes occurred between April 15 and Sept. 30, according to CMS' initial report on the independent dispute resolution process.
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The Pennsylvania Insurance Department ordered Capital Blue Cross to pay restitution plus interest for wrongly denied claims, in addition to an $85,000 fine, pennlive.com reported Jan. 4.
Optum is hiring 1,400 employees from Brewer, Maine-based Northern Light Health and will manage parts of the system's operational functions.
HHS is giving states greater flexibility to cover social determinants of health initiatives under their Medicaid program.
Several Blue Cross Blue Shield companies have formed a medication contracting organization, Synergie Medication Collective, aimed at reducing high specialty drug costs.
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A case filed by two former UnitedHealth executives who sued the company for allegedly underpaying them for a billion-dollar business line they helped create has quietly closed, the Minneapolis/St. Paul Business Journal reported Jan. 3.
Reviewing and approving prior authorizations has been a necessary but often cumbersome challenge.
Perceived cost is the main barrier to uninsured individuals seeking health coverage on state marketplaces, a survey from Florida Blue found.
Some methadone treatment providers are concerned Medicare Advantage prior authorization delays are preventing beneficiaries from receiving necessary treatments in time, Roll Call reported Jan. 4.
Centene boosted its projected earnings per share for 2024 after scoring more Medicaid managed care contracts in California.