Texas is at least the 12th state to settle with St. Louis-based Centene Corp. over allegations that it overcharged Medicaid prescription drug programs.
Category: Insurers
Court Ruling May Spur Competitive Health Plans to Bring Back Copays for Preventive Services
The Affordable Care Act required that health insurers provide many medical screenings and prevention services at no out-of-pocket cost to health plan members. But insurers and employers may consider adding cost sharing for preventive services now that a federal court ruled the ACA’s mandate is unconstitutional.
Medical Coding Creates Barriers to Care for Transgender Patients
The codes used by U.S. medical providers to bill insurers haven’t caught up to the needs of trans patients or even international standards. Consequently, doctors are forced to get creative with what codes they use, or patients spend hours fighting big out-of-pocket bills.
Timely Mental Health Care Is a Key Factor in Strike by Kaiser Permanente Workers
A new California law requires timely follow-up appointments for mental health and addiction patients. But striking workers at Kaiser Permanente in Northern California say patients continue to wait up to two months.
Health Insurance Price Data: It’s Out There, but It’s Not for the Faint of Heart
Health insurers and self-insured employer plans are now required to post their negotiated rates for almost every type of medical service. But navigating through the trove of information is no easy task.
Even Well-Intended Laws Can’t Protect Us From Inaccurate Provider Directories
State and federal laws require health plans to offer accurate lists of participating doctors and facilities, but consumers still struggle to get timely appointments with providers.
Ad Targeting Manchin and AARP Mischaracterizes Medicare Drug-Price Negotiations
The advocacy group American Commitment said empowering Medicare to negotiate drug prices would raid it of billions of dollars. Drug pricing experts say that that’s not the case and that such policies would instead reduce costs for the Medicare program and seniors.
No-Bid Medicaid Contract for Kaiser Permanente Is Now California Law, but Key Details Are Missing
California Gov. Gavin Newsom signed a bill last month that authorizes a statewide Medicaid contract for HMO giant Kaiser Permanente. But details still need to be worked out in a memorandum of understanding.
No-Bid Medicaid Contract for Kaiser Permanente Is Now California Law, but Key Details Are Missing
California Gov. Gavin Newsom signed a bill last month that authorizes a statewide Medicaid contract for HMO giant Kaiser Permanente. But details still need to be worked out in a memorandum of understanding.
Computer Glitches and Human Error Still Causing Insurance Headaches for Californians
Covered California and Medi-Cal share a computer system for eligibility and enrollment. Nearly a decade since the Affordable Care Act expanded coverage options in the state, enrollees can be diverted to the wrong program — or dropped altogether — if erroneous information gets into the system.
