UnitedHealthcare has acquired Rocky Mountain Health Plans, a not-for-profit insurance provider based in Grand Junction, Colo.
UnitedHealthcare and Amerigroup paid $6.6 million in improper and questionable Medicaid physician payments in New York, according to an audit by the state comptroller.
Attempts by the CMS to limit the use of special enrollment periods to obtain exchange coverage do not go far enough to ensure that the circumstances won't be abused by those seeking to game the system, according to health plan critics.
UnitedHealthcare claims in a new federal lawsuit that American Renal Associates, a publicly traded dialysis company, engaged in a scheme to switch patients from Medicare and Medicaid coverage to UnitedHealthcare coverage to greatly boost payments, the New York Times reports.
Blue Cross and Blue Shield of Minnesota is cutting back its participation in the state's Affordable Care Act exchange after losing nearly $300 million in the individual market in 2015. Narrow networks have become the primary cost-control tool for insurers now.
The CMS says it's well on its way to dragging hospital systems into the brave new world of risk-based contracting. The systems say, not really.
Indiana awarded new managed Medicaid contracts to four out of five bidding private health insurers. UnitedHealthcare was the lone company to miss the cut because its proposed costs were too high.
UnitedHealth Group has appointed John Rex, the CFO of UnitedHealth's Optum unit, as its next CFO. The move shows how Optum, whose services include a growing PBM and data analytics consulting, has risen to a level of importance that competes with UnitedHealth's traditional health insurance division.
UnitedHealthcare, the largest health insurer in the nation, will not sell Affordable Care Act plans to Illinois consumers come fall.
New York insurers asked for large premium increases as a way to counteract rising costs, and in some cases, gargantuan losses. Insurers selling plans to individuals requested a 17.3% average increase and those selling small-group plans asked for an average 12% rate hike.
A new federal rule will encourage states to ramp up auditing of Medicaid managed-care insurers, many of which keep their medical spending hidden from public view.
Insurers that pull out of the Affordable Care Act marketplaces can nudge enrollees to follow them but can't automatically sign them up for off-exchange plans. The CMS issued guidance on the matter just days after UnitedHealth Group said it plans to ditch the exchanges in most states.