Payer

Health insurers have responded to Hurricane Ian by authorizing prescription refills, waiving prior authorizations, and adding emergency resources and support. 

Centene will pay $14.2 million to Massachusetts, the latest state the Medicaid managed care organization has paid to settle allegations it overbilled state Medicaid programs for pharmacy services, Kaiser Health News reported Sept. 29. 

Molina Healthcare of Florida is suspending prior authorization requirements to assist members and providers affected by Hurricane Ian. 

The National Committee for Quality Assurance has named the top-performing Medicare plans of 2022 based on factors that include care quality, patient satisfaction and efforts to keep improving.

The National Committee for Quality Assurance has named the top-performing Medicaid plans of 2022 based on factors that include care quality, patient satisfaction and efforts to keep improving.

Nevada's public health plan set to launch in 2026 could save the state up to $1.3 billion in healthcare costs over the following decade, according to a state report released Sept. 23.

Utilization management (UM) has become a huge administrative burden for both providers and payers due to multiple data sources and manual processes. By using artificial intelligence (AI) technology and real-time data, all parties can significantly reduce current utilization management review…

The Health Resources and Services Administration should do more to clarify which contraceptives are required to be covered at no cost under the ACA and make sure new methods are added to coverage requirements, healthcare attorneys write in an opinion…

Cigna is launching a new concierge service, Pathwell, combining elements from Evernorth, its health services arm, to treat complex conditions. 

A Delaware retiree advocacy group is suing the state over its decision to move retired state employees to a Medicare Advantage plan managed by Highmark Delaware, Delaware Public Radio reported Sept. 27.