The insurer says employers can save up to 15% on premiums compared to a traditional PPO, while providing access to care from more than 5,000 physicians and 15 medical centers in the Banner Health Network. Plan members receive primary care and urgent care visits for a $0 copay, 24/7 telehealth visits and care coordination driven by their...National News
Juries in Nevada courts awarded $60 million in punitive damages on Tuesday following a $2 million award for damages last week after finding defendants, including UHC, liable for shorting payments to out-of-network emergency medical providers in Nevada.
According to Reuters, The Nevada breach-of-contract lawsuit was filed in April...
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...
The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) published a study on September 23 that found 20 Medicare Advantage companies generated a disproportionate share of federal overpayments by manipulating chart reviews and health risk assessments (HRA) to drive up reimbursement.
Total...
This week, the Centers for Medicare and Medicaid Services (CMS) is learning from prior models and plans to make adjustments within Medicare Advantage for dual eligibles and hospice care. In other MA news, Anthem and UnitedHealthcare were penalized for failing to meet the medical loss ratio (MLR) threshold of 85%.
CMS is moving forward...News
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
UnitedHealthcare's announcement it would begin denying payments for non-urgent emergency department visits was met with fierce criticism from hospitals, doctors groups and patient advocacy organizations. As a result the insurance giant has said it will delay the policy.
UnitedHealthcare covers nearly 425,000 Arizonans on Medicaid...Arizona News
The nation's largest health insurer by membership announced a new policy to deter patients from seeking care in hospital emergency departments. UnitedHealthcare announced the change would take effect on July 1, and it would evaluate emergency room claims using "a number of factors" to determine whether or not the issue was truly an...News
Enhancements to UnitedHealthcare’s integrated approach to medical and specialty benefits may help eligible employers save up to 4% by combining medical benefits with vision, dental and financial protection plans.
UnitedHealthcare has introduced various enhancements to its integrated approach to medical and specialty benefits,...National Reports & Surveys
Over the course of two years, companies spent $2.5 billion to treat employees' asthma, diabetes, back disorders, hypertension, mental health and substance abuse, according to a new study by UnitedHealthcare and Health Action Council.
UnitedHealthcare reviewed all claims issued by the Health Action Council's 57 nationwide employer...Arizona News
Racial and ethnic health disparities are rooted in inherited inequality and prejudice, with racial and ethnic minorities experiencing inequity in medical treatment and poor health outcomes.
Populations of vulnerable people both in the United States and internationally are more likely to experience more severe effects and higher...Arizona News
Window shopping is available on HealthCare.gov before the 2021 Open Enrollment Period (OEP) starts November 1, but those with qualifying events, including a recent job loss, can enroll now for 2020 coverage.
Next year's proposed rate changes range from a decrease of about 7% to an increase of about 9% as more Arizonan's are expected...Arizona News
It was a nail biter, but late last week UnitedHealthcare finally confirmed it would be offering individual and family plans in Maricopa County during the upcoming open enrollment on HealthCare.gov beginning November 1.
UnitedHealthcare is already a major local market force with nearly 1.7 million Arizona members across commercial,...
Medicare open enrollment begins this week with Medicare Advantage enrollment expected to climb as it has consistently in past years. As the Centers for Medicare and Medicaid Services announce new cost sharing information for Part D plans, and new brokers prepare to enter the market, here are some things to look out for this enrollment...
In the early months of the pandemic, the federal Medicare program and private health insurance companies wanted to encourage people to use alternatives to in-person care by talking with a doctor over video or by telephone. There has been a 3,200% spike in telemedicine visits in Arizona, according to AHIP.
Now, some Americans will...
This month's newsletter covers how Arizona hospitals and healthcare providers are faring financially during the public health emergency, AHCCCS enrollment trends, the status of the individual market and our popular Arizona Comings & Goings section.
The Hertel Report newsletters and data editions are only available to members...
This funding is part of UnitedHealthcare’s $12.3 million in Empowering Health grants concerned with expanding access to care and addressing the social determinants of health for people in underprivileged communities and uninsured individuals.
Three community-based organizations in Arizona are receiving $105,000, which...Arizona News
UnitedHealthcare, already a major market force in Arizona with 1.6 million members, is intending to offer exchange plans in new states. In 2017, after citing enormous losses, the insurer dropped its exchange offerings across multiple states, including Arizona, leaving consumers in 13 of the state's counties with only one choice: Blue...Arizona News
Members with UHC commercial fully insured benefits will receive credits ranging from 5% to 20% depending upon the specific plan. Credits will be applied to premium billings received by members in June.
The nation's largest insurer is mindful of the costs of commercial coverage and that as unemployment continues to rise, the...
