CMS halts Medicaid redeterminations in 'half-dozen states'
CMS has required around a half-dozen states to pause procedural terminations to correct errors through the Medicaid redetermination process, CMS officials told reporters on a July 19 press call.Elevance Health loses 135,000 Medicaid members in 1st months of redeterminations
Elevance Health is expecting many consumers who have lost Medicaid to transition to other forms of coverage, executives told investors.California's state employee health plan premiums to increase by 11%
California's health plan costs for state employees and retirees are rising at an "unsustainable" rate, state officials said.医疗补助管理式医疗organizations deny 1 in 8 prior authorization requests: OIG
HHS' Office of Inspector General raised concerns about the rate of prior authorization denials in Medicaid managed care and a lack of state oversight of these denials in an audit published July 17.Elevance Health posts $1.9B profit in Q2
Elevance Health posted double-digit revenue growth and beat investor expectations in the second quarter of 2023, according to the company's earnings report published July 19.California Medical Association can sue Aetna over its referral policy, court rules
The California Supreme Court ruled that the state's medical association has standing to sue Aetna's operations in California for allegedly interfering with the medical judgment of physicians who refer patients to out-of-network providers.The 9 highest paid CEOs at publicly traded health insurance companies | 2022
The following leaders were the nine highest paid chief executives at publicly traded health insurance companies in 2022, according to public financial filings.CMS: Marketplaces are ready to be 'landing spot' for those losing Medicaid coverage
CMS is ramping up efforts to connect over 2 million people who have been disenrolled from Medicaid coverage to ACA plans.Kaiser will honor deductibles, out-of-pocket caps for Friday Health members in Colorado
Friday Health Plan members in Colorado must enroll in new insurance by Aug. 31 to avoid a gap in coverage, the state's division of insurance said July 17.3 ways to reduce Medicare Advantage overpayments
Medicare Advantage overpayments may be higher than the the Medicare Payment and Advisory Commission estimates, a June study from researchers at the Los Angeles-based University of Southern California found.How payers' executive compensation stacks up with other healthcare giants
Pfizer CEO Albert Bourla, PhD, was the highest-paid executive out of the 11 healthcare firms in the top 50 companies on the 2023 Fortune 500 rankings.100 fittest cities in America, per Elevance Health
Arlington, Virginia is the fittest city in America for the 6th year in a row, according to the 16th annual American College of Sports Medicine Fitness Index published July 18 alongside the Elevance Health Foundation.Humana in the headlines: 8 recent updates
Humana is warning of rising medical utilization rates and has published new research findings.Centene in the headlines: 8 recent updates
Centene received workforce awards and scooped up a behavioral health contract from Optum in the past month.How 7 payers are using AI
Payers are using artificial intelligence to speed up administrative processes, improve customer services and analyze data.3 reasons medical costs are rising, according to payers
Payers have warned of increasing medical costs, driving up medical loss ratios.UnitedHealthcare preparing for rising Medicare Advantage costs in 2024
UnitedHealthcare is expecting medical costs for its Medicare Advantage members to keep rising, the company's top executives said.50 things to know about Optum
Optum, UnitedHealth Group's health services arm, is a major player in many corners of the healthcare industry, including pharmacy, primary care and revenue cycle management.California prior authorization bill advances
A California bill aiming to reform the prior authorization process has advanced out of the Assembly health committee, according to the California Medical Association.More than 2 million have been disenrolled from Medicaid. 75% are for procedural reasons
More than 2 million people have lost Medicaid coverage during the redetermination process as of July 13, according to KFF's Medicaid enrollment and unwinding tracker.
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