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Evernorth eyes behavioral health with care management program
In an effort to better align on quality care and reimburse providers for delivering improved health outcomes, Evernorth Health Services is launching a measurement-based care program for its behavioral health network.
This, said Evernorth, represents th…
OIG: Aetna may have received more than $25 million in MA overpayments
A new audit by the Department of Health and Human Services’ Office of the Inspector General has found that health insurer Aetna received about $25.5 million in Medicare Advantage overpayments in 2015 and ’16.
Brightside Health to offer telemental health through Medicare, Medicaid
Mental Health provider Brightside Health is teaming with Optum and other healthcare organizations to offer telehealth-based mental healthcare to Medicare and Medicaid beneficiaries.
In addition to Optum – through which Brightside will serve UnitedHealt…
ProHealth Care teaming with Optum on revenue cycle, other tech
ProHealth Care, based in Wisconsin, is teaming up with Optum, part of UnitedHealth Group, on revenue cycle management and other technology in an effort to shore up its tech solutions and enhance patient care.
HHS proposed rule to update policies on research misconduct
The Office of Research Integrity has issued a Notice of Proposed Rulemaking (NPRM) to update the 2005 Public Health Service Policies on Research Misconduct. The current regulation establishes the requirements for addressing research misconduct in PHS-f…
AI is creating a complex landscape for healthcare executives
Artificial intelligence, as an emergent technology, is poised to transform healthcare in a number of ways. There are a lot of expectations being placed on the technology, and in some cases it can deliver. It has shown promise in crunching large amounts…
Molina loses Medicaid long-term services contract in Indiana
Molina Healthcare will cease administering a long-term services Medicaid contract called Indiana Pathways for Aging, according to regulatory filings published this week.
Court strikes down HHS rule allowing insurers to exclude copay assistance
A federal judge has struck down a Trump administration rule that allowed health insurers to exclude drug manufacturer copay assistance towards a beneficiary’s out-of-pocket costs.
Under the Trump rule, these “copay accumulator” policies meant patients …
Insurers tout Medicare Advantage benefits
Healthcare insurers have been rolling out their new Medicare Advantage offerings and are touting benefits that range from cost to ease of access, ahead of open enrollment starting October 15.
UnitedHealthcare, for example, will expand its coverage area…
Cigna will pay $172 million for allegedly overcharging Medicare Advantage
Health insurer Cigna has agreed to pay $172 million to resolve allegations that it padded its reimbursement by submitting false Medicare Advantage diagnostic codes.
The agreements resolve a False Claims Act lawsuit brought by a whistleblower and the fe…
