Current and former Centene board members, along with former senior executives, have beat a pension fund derivative lawsuit alleging the company overbilled state Medicaid programs for pharmacy services.
Payer
A trial is underway to determine if Florida failed to properly notify Medicaid beneficiaries it disenrolled during the unwinding process, the Miami Herald reported July 11.
Aetna failed to accurately calculate qualified payment amounts for air ambulance services, CMS' first audit of an insurer's No Surprises Act compliance found.
Investing in digital and artificial intelligence technologies is a higher priority for payer CFOs than for their health system counterparts, according to a July 10 report from Deloitte.
CMS published updated star ratings for dozens of Medicare Advantage plans, and a federal judge paused a new CMS regulation that would cap the amount insurers can pay brokers who sell their plans.
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Blue Cross and Blue Shield of Louisiana has moved its care management processes and several provider services to the Epic Payer Platform.
Two Blue Cross Blue Shield plans have now lost in federal court for terminating employees that refused to get vaccinated against COVID-19, and other insurers are facing similar lawsuits.
As insurers continue to face major financial pressures related to covering weight loss drugs, many are steering more patients toward bariatric surgery to achieve similar results.
UnitedHealth Group and several of the company's leaders are facing a shareholder derivative lawsuit alleging they failed to disclose that the Justice Department opened an antitrust investigation into the company.
Medicare Advantage organizations are facing major challenges, including rising utilization rates, reduced reimbursements, and an evolving regulatory landscape.