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