Employers are increasingly moving retirement plans to Medicare Advantage health coverage, but the retirees in question are often upset with these moves.
The City of New York recently attempted such a pivot, which led to a high-profile fight in the courtroom and public politics. Perhaps most surprisingly, the City and some unions...
It's the time of year for insurers to file their fourth quarter (Q4) earnings reports for 2022. This week, Molina, Kaiser Permanente and Oscar Health posted financial metrics.
Oscar Health beat the odds in 2022 by improving its medical loss ratio from 88.9% in 2021 to 85.3%, Modern Healthcare reports. But the healthtech company still...National News
As the COVID-19 public health emergency winds down, insurers of Medicaid managed care plans are bracing to lose membership.
Centene is expecting it will lose 2.2 million Medicaid members during the redetermination process over the next year. According to Modern Healthcare, the company had 16 million Medicaid members at the end of...Arizona News
As discussions continue and the contract is being finalized, Phoenix Children’s remains an in-network provider for families with Cigna employer-sponsored health coverage. The original contract between the provider and payor was set to expire January 31, 2023.
President and CEO Robert L. Meyer said the children's hospital is...Arizona News
Phoenix Children's commercial contract with Cigna expires Jan. 31, 2023 and there's no new agreement yet.
One of the largest pediatric healthcare systems in the country, Phoenix Children's is located in central Phoenix and is already out of network for Arizona Cigna Marketplace and Medicare Advantage plan members, but Cigna's...Arizona News
This year's surprising exit of Bright Health on the Marketplace leaves $4 billion in ACA revenue up for grabs for brand name giants including UnitedHealthcare, Centene, Cigna, and CVS, but it's some lesser known short-term plans and Healthcare Sharing Ministries that are also gaining consumer attention with deceptive marketing touting...
Most shoppers who qualify for a subsidy won't feel the cost of rising Marketplace premiums and with eligibility expanded to include the cost of family coverage, HealthCare.gov may see the busiest season ever as it celebrates its 10th open enrollment period (OEP) Nov. 1, 2022 through January 15, 2023.
Eight insurers, but not...
Seven insurers, but not Bright Health, are offering individual and family coverage in Arizona on HealthCare.gov including last year's newcomers Banner/Aetna and Medica Community Health Plan. We reviewed the plan data from the Arizona Department of Insurance and Financial Institutions and provide readers a Marketplace snapshot.
Nearly...
Medicare Advantage enrollees who use insulin may not know the insulin cost cap limits all monthly out-of-pocket costs for insulin to $35 -- and that could influence how they select their Medicare Advantage plans during the open enrollment period.
For the current open enrollment period, the insulin cost cap was not factored into the...
As seniors, the Centers for Medicare and Medicaid Services (CMS) and Medicare Advantage (MA) plans gear up for a landmark Medicare Advantage Open Enrollment Period beginning October 15, Medicare Advantage on the whole is in hot water.
Last week, the New York Times published an earthshaking story documenting the extent to which...
Cigna contracts with MultiPlan, the largest PPO network in the country. The insurer was accused of intentionally underpaying provider claims and increasing administrative fees in a lawsuit filed in a Connecticut federal court.
The American Medical Association joined the Medical Society of New Jersey and the Washington State Medical...CMS Rules
The No Surprises Act has been a hot-button point of contention among insurers and providers as physician groups feel threatened by the leverage that insurers are given through the Act's enforcement. The Medical Group Management Association (MGMA) sent a letter to the U.S. Department of Health and Human Services (HHS) and the Centers for...National News
Health insurance technology startups have struggled to meet industry expectations, with several of the most lauded companies losing money quarter-to-quarter despite significant growth. But these insuretech startups' CEOs are receiving ample bonuses despite poor corporate performance.
A few recent examples: Bright Health Group recorded...
The increasing burden of prior authorization, as well as the rise of “fail first” policies has become costly and harmful for patients – so much so that the American Medical Association (AMA) has engaged a law firm to pursue curtailing prior authorization.
According to the American Journal of Managed Care (AJMA), Barbara...
The U.S. Justice Department officially announced a lawsuit to stop UnitedHealth Group’s acquisition of Change Healthcare this week, while companies ranging in size from startups like Sesame to mega-corporations such as Tenet and Cigna continue to seek new ways to utilize software and technology in healthcare – either for profit or...
The Centers for Medicare and Medicaid Services (CMS) released its star ratings for Medicare Advantage Part C and Part D star ratings last Thursday, ahead of Medicare open enrollment, which begins October 15. Medicare Advantage (MA) plans get a star rating from one to five each year based on performance metrics including patient...
The Centers for Medicare & Medicaid Services (CMS) released key information for Medicare Advantage and Part D prescription drug plans in advance of the 2022 annual open enrollment period (OEP). Marketing and advertising for most MA plans starts October 1 with plan sales beginning October 15 and ending December 7, 2021.
Arizona...
This week a large amount of analysis on how the Affordable Care Act, insurance rates and private insurance faired during the ongoing COVID-19 pandemic. Also, due to increased enrollment during the special enrollment period and the need for health insurance spurred by pandemic-related job loss has encouraged insurance giant...National News
The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) ran an audit on Aetna's Medicare Advantage (MA) business according to parent company CVS Health. The HHS OIG has cracked down on inaccurate adjustment scores submitted by MA plans including Humana and Anthem.
Aetna's MA reimbursement is...Arizona News
Starting July 1, 2021, Cigna Administered by Oscar will offer small businesses access to member-first health insurance products across 15 Arizona counties.
Cigna and Oscar rolled out this product in 2020 primarily for benefiting small businesses across the United States. Since its launch, the product has strived to offer affordable...
