Humana is reportedly exiting the Colorado group insurance market, Colorado Politics reported Oct. 24.
Payer
Pennsylvania lawmakers are considering a bill that supporters say will streamline the prior authorization process, CBS affiliate WHP reported Oct. 24.
Payers are expanding Medicare Advantage plans to new markets for 2023, and many are facing increased scrutiny and legal action for overpayments.
Navigation difficulties were cited as the top reason beneficiaries switched their health insurance plans, according to an Oct. 18 report from the professional services company Accenture.
Humana and Boston-based Cohere Health are expanding their partnership again to enable a digitized prior authorization process nationwide for cardiovascular and surgical services.
Advertisement
About a third, or 31.6 percent, of the 57 Medicare Advantage plans that earned five stars from CMS in 2023 are a part of the Alliance of Community Health Plans, a trade group representing nonprofit payers.
Elevance Health has expanded its home-based nursing management company, myNEXUS, to Medicare Advantage members in 15 states, CEO Gail Boudreaux said Oct. 19 during a call with investors.
As North Carolina shifts its Medicaid system to managed care, Duke University Margolis Center for Health Policy researchers recommend the state integrates care for dual-eligible beneficiaries to the most comprehensive level possible.
Congress and government regulators have the power to stop Medicare Advantage fraud, Richard Kronick, PhD, said in a letter to the New York Times.
CMS awarded fewer Medicare Advantage plans with five-star ratings for 2023 than in 2022. A total of 57 Medicare Advantage plans were granted top ratings this year, and some states have more options for top plans than others.