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Iowa agency waives sanctions at start of state's new Medicaid system

By Associated Press  |  August 21, 2016

The state agency overseeing Iowa's transition to a privatized Medicaid program waived any possible sanctions against three insurance companies during the first two months of the new system, and it didn't inform health advocates or lawmakers about the plans.

CMS may crack down on third-party groups that subsidize ACA premiums

By Shannon Muchmore  |  August 18, 2016

The CMS is asking the public for information about providers and organizations that may be steering Medicare- or Medicaid-eligible patients toward the Affordable Care Act's insurance exchanges in order to receive higher reimbursement rates.

Aetna pullout heightens pressure for ACA exchange fixes as elections near

Aetna pullout heightens pressure for ACA exchange fixes as elections near

By Harris Meyer  |  August 16, 2016

The startling withdrawal of Aetna from many Affordable Care Act exchanges has accelerated the search for ways to preserve competition in those markets, such as making participation a condition for Medicaid contracts or a concession for proceeding with proposed mergers.

Apps for Rx sticker shock

Apps for Rx sticker shock

By Adam Rubenfire  |  July 30, 2016

A number of insurers, pharmacy benefit managers and technology companies are developing smartphone and computer apps to provide accurate drug-pricing information for patients and physicians.

Under construction: Risk-based reimbursement

Under construction: Risk-based reimbursement

By Dave Barkholz  |  June 18, 2016

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.

New Indiana Medicaid contracts snub UnitedHealthcare

New Indiana Medicaid contracts snub UnitedHealthcare

By Bob Herman  |  June 18, 2016

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.

UnitedHealthcare leaving Illinois ACA exchange

UnitedHealthcare leaving Illinois ACA exchange

By Kristen Schorsch, Crain's Chicago Business  |  May 31, 2016

UnitedHealthcare, the largest health insurer in the nation, will not sell Affordable Care Act plans to Illinois consumers come fall.

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