Anthem Blue Cross of California is holding off on its evaluation and management claim downcoding policy until March 1, pending California Department of Managed Health Care review, according to a Feb.

Oakland, Calif.-based Kaiser Permanente is suing nine liability insurers for breach of contract, alleging they have refused to cover any portion of its $556 million settlement with the federal ...

CMS is moving forward with the next phase of its national directory of Medicare providers, according to Feb. 18 document. The document outlines plans to “beta launch” the directory of providers, ...

Humana’s healthcare services division CenterWell has completed its acquisition of MaxHealth, a Tampa, Fla.-based primary care network focused on adults and seniors, the company said Feb. 13. MaxHealth ...

UnitedHealth Group Board Chairman and CEO Stephen Hemsley privately invested in healthcare companies that work with UnitedHealth or have competing offerings, The Wall Street Journal reported Feb. 16.

There’s “a hunger for a different kind of dialogue” when it comes to relations between payers and providers, according to Aetna President Steve Nelson. Mr. Nelson laid out a vision for Aetna that ...

Medicare Advantage now covers about 55% of eligible beneficiaries nationwide — more than 35 million people — but health systems are confronting a question that until recently felt almost taboo: What ...

Paul Markovich, president and CEO of Ascendiun, the parent company of Blue Shield of California, is not one to sugarcoat the state of the healthcare system. “I don’t see how you can look at it and say ...

UnitedHealthcare and Knoxville, Tenn.-based Tennova Healthcare appear to be on the brink of ending their contract beginning March 1, according to a WBRI report. Air Evac Lifeteam has sued Medical ...

Becker’s connected with 17 health plan leaders to learn how their organizations are shifting their priorities in response to continued medical cost trends and affordability concerns. Like what you see ...

Optum has launched a pair of AI-driven prior authorization products, one designed to speed up submissions on the provider side and another to accelerate clinical reviews for payers. The ...