As administrative costs rise and reimbursement grows more complex, both health plans and providers are under increasing pressure to improve the payment experience. Faster payment remains important, ...
Arkansas will begin a soft launch of Medicaid work and community engagement requirements for enrollees in its Medicaid expansion program on July 1, with full enforcement set to begin Jan. 1, 2027.
Virginia Democratic Gov. Abigail Spanberger signed HB736 into law April 6, furthering prior authorization reform in the state. Effective in 2027, the law establishes a minimum duration requirement.
Priority Health is estimated to have collected at least $4.4 million in Medicare Advantage overpayments throughout 2018 and 2019, according to a March audit from the HHS Office of the Inspector ...
Nebraska will roll out Medicaid work requirements in May, making it the first expansion state to implement these provisions under HR 1. Here are four notes leading up to Nebraska’s launch: 1. Medicaid ...
Blue Cross Blue Shield plans faced widespread financial pressure in 2025, with several major insurers posting operating losses as medical and pharmacy costs continue to climb. The struggles played out ...
AP of South Florida, a Florida-based insurance brokerage, has agreed to plead guilty to one count of major fraud against the U.S. for its role in a fraudulent ACA enrollment scheme. In a parallel ...
CMS has issued operational guidance to states regarding how to implement H.R. 1’s Medicaid coverage restrictions for noncitizens, which take effect Oct. 1. On April 8, the agency outlined how states ...
The day after CMS released its final 2027 Medicare Advantage and Part D payment rule, Chris Klomp, director of Medicare and deputy administrator at the agency, sat down with Health Tech Nerds Radio ...
In early February, Republican lawmakers in Oklahoma introduced a state bill and joint resolution that could shake up the future of Medicaid expansion. The April 6 version of HB 4440 poses a state ...
North Carolina system to start going out of network with UnitedHealthcare in April By: Elizabeth Casolo ...
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